Planté-Bordeneuve Thomas, Berardis Silvia, Bastin Pierre, Gruson Damien, Henri Laurence, Gohy Sophie
Department of Pneumology, Cliniques universitaires Saint-Luc, Avenue Hippocrate 10, 1200, Brussels, Belgium.
Department of Paediatric Pneumology, Cliniques universitaires Saint-Luc, Brussels, Belgium.
Sci Rep. 2021 Apr 8;11(1):7719. doi: 10.1038/s41598-021-87099-w.
Vitamin D toxicity is associated with accidental overdoses due to manufacturing or intake errors and its secondary hypercalcemia can result in severe morbidity. Although patients with cystic fibrosis are potentially at increased risk for this intoxication as prescription of vitamin D preparations is a common practice in this population, the frequency of such events is currently unknown. We performed a retrospective analysis of all the files of cystic fibrosis patients followed at the Cliniques universitaires Saint-Luc over a 10-year period, recording 25(OH)- and 1,25(OH)vitamin D levels as well as demographic data, lung function tests, Pseudomonas aeruginosa infection and results from pharmacological analysis of magistral liposoluble vitamins preparations. A total of 244 patients were included in the study. 13 patients (5%) had serum vitamin D levels corresponding to vitamin D overdose. Patients who had experienced an overdose were more likely to be F508del homozygous or suffer from exocrine pancreatic insufficiency. 2 patients developed significant hypercalcemia necessitating monitoring and hospitalization. Errors in the preparation of magistral liposoluble vitamin pills were identified in several intoxicated patients. Retrospective assessment of the dosing errors with the local pharmacists showed that trituration and dosing errors were their most frequent causes.
维生素D中毒与因生产或摄入错误导致的意外过量服用有关，其次发性高钙血症可导致严重的发病情况。尽管囊性纤维化患者因在该人群中普遍开具维生素D制剂而有潜在的更高中毒风险，但此类事件的发生频率目前尚不清楚。我们对圣卢大学医院在10年期间随访的所有囊性纤维化患者档案进行了回顾性分析，记录了25(OH)-和1,25(OH)维生素D水平以及人口统计学数据、肺功能测试、铜绿假单胞菌感染情况和自制脂溶性维生素制剂的药理分析结果。共有244名患者纳入研究。13名患者（5%）的血清维生素D水平符合维生素D过量。经历过量服用的患者更可能是F508del纯合子或患有外分泌性胰腺功能不全。2名患者出现明显高钙血症，需要监测和住院治疗。在几名中毒患者中发现了自制脂溶性维生素丸剂制备过程中的错误。与当地药剂师对剂量错误进行的回顾性评估显示，研磨和剂量错误是最常见的原因。
