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阳光维生素的阴暗面:一例因过量摄入维生素D导致的急性肾衰竭和高钙血症

The Dark Side of the Sunshine Vitamin: A Case of Acute Renal Failure and Hypercalcaemia From Vitamin D Overconsumption.

作者信息

Khan Sheharyar, Tariq Muhammad Wasim, Akhtar Muhammad, Raza Muhammad Tanseer Sibtain, Manzoor Muhammad

机构信息

Emergency Medicine, United Lincolnshire Hospitals National Health Service (NHS) Trust, Grantham and District Hospital, Grantham, GBR.

Endocrinology, United Lincolnshire Hospitals National Health Service (NHS) Trust, Pilgrim Hospital, Boston, GBR.

出版信息

Cureus. 2024 Sep 26;16(9):e70237. doi: 10.7759/cureus.70237. eCollection 2024 Sep.

DOI:10.7759/cureus.70237
PMID:39463498
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11512663/
Abstract

Vitamin D toxicity is a rare but potentially serious condition that can lead to severe hypercalcaemia and subsequent complications, such as acute renal failure, nephrocalcinosis, congestive heart failure and coronary calcium deposition, resulting in myocardial injury. We present a case of a 76-year-old male patient who developed severe hypercalcaemia and acute kidney injury due to excessive long-term over-the-counter vitamin D supplementation. The patient was initially treated with aggressive intravenous fluids and furosemide. However, a failed effective response prompted the addition of pamidronate, resulting in the gradual improvement of hypercalcaemia and renal function. We have presented, in this case, a rare adverse effect of vitamin D toxicity and its multiorgan effect.

摘要

维生素D中毒是一种罕见但可能严重的病症,可导致严重高钙血症及随后的并发症,如急性肾衰竭、肾钙质沉着、充血性心力衰竭和冠状动脉钙沉积,进而导致心肌损伤。我们报告一例76岁男性患者,因长期过量服用非处方维生素D补充剂而出现严重高钙血症和急性肾损伤。患者最初接受积极的静脉补液和呋塞米治疗。然而,因治疗效果不佳,加用了帕米膦酸盐,高钙血症和肾功能逐渐改善。我们在此病例中展示了维生素D中毒的罕见不良反应及其多器官影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9bac/11512663/ef1e5f58682e/cureus-0016-00000070237-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9bac/11512663/2a6a8952c4c4/cureus-0016-00000070237-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9bac/11512663/ef1e5f58682e/cureus-0016-00000070237-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9bac/11512663/2a6a8952c4c4/cureus-0016-00000070237-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9bac/11512663/ef1e5f58682e/cureus-0016-00000070237-i02.jpg

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本文引用的文献

1
2021 Annual Report of the National Poison Data System (NPDS) from America's Poison Centers: 39th Annual Report.美国毒物控制中心协会国家毒物数据系统(NPDS)2021年度报告:第39次年度报告。
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KDIGO 2017 Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD).KDIGO 2017慢性肾脏病-矿物质和骨异常(CKD-MBD)诊断、评估、预防及治疗临床实践指南更新
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Cystatin C Predicts Renal Recovery Earlier Than Creatinine Among Patients With Acute Kidney Injury.
在急性肾损伤患者中,胱抑素C比肌酐更早预测肾功能恢复。
Kidney Int Rep. 2017 Nov 3;3(2):337-342. doi: 10.1016/j.ekir.2017.10.012. eCollection 2018 Mar.
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Trends in Use of High-Dose Vitamin D Supplements Exceeding 1000 or 4000 International Units Daily, 1999-2014.1999 - 2014年每日使用超过1000或4000国际单位高剂量维生素D补充剂的趋势。
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Vitamin D-Mediated Hypercalcemia: Mechanisms, Diagnosis, and Treatment.维生素D介导的高钙血症:机制、诊断与治疗
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BMJ. 2014 Apr 1;348:g1903. doi: 10.1136/bmj.g1903.
7
Narrative review: furosemide for hypercalcemia: an unproven yet common practice.叙述性综述:速尿治疗高钙血症:一种未经证实但常见的做法。
Ann Intern Med. 2008 Aug 19;149(4):259-63. doi: 10.7326/0003-4819-149-4-200808190-00007.
8
Pamidronate treatment of hypercalcemia caused by vitamin D toxicity.帕米膦酸盐治疗维生素D中毒引起的高钙血症。
J Pediatr Endocrinol Metab. 2007 Nov;20(11):1241-8. doi: 10.1515/jpem.2007.20.11.1241.