Lee D C, Lee G Y
Department of Emergency Medicine, North Shore University Hospital, Manhasset, NY 11030, USA.
J Toxicol Clin Toxicol. 1998;36(7):719-21. doi: 10.3109/15563659809162621.
Pamidronate disodium, a bone resorption inhibitor through osteoclast mediation, has been used to treat chronic hypercalcemia secondary to malignancy and chronic renal failure. We report the use of pamidronate for acute, severe hypercalcemia secondary to iatrogenic vitamin D poisoning.
A 77-year-old female nursing home resident was inadvertently administered 50,000 units of oral vitamin D daily for 6 days. The patient presented with lethargy, abdominal pain, and vomiting. The patient's initial serum calcium concentration was 5.25 mmol/L (21 mg/dL). The patient was initially treated with hydration and furosemide but developed congestive heart failure. Pamidronate was used and calcium concentrations normalized by 24 hours after treatment.
We report a case of the use of pamidronate for significant hypercalcemia secondary to acute vitamin D poisoning. Although evidence of congestive heart failure was evident, dialysis was avoided without significant sequelae. Pamidronate therapy should be considered in patients with hypercalcemia secondary to acute vitamin D poisoning.
帕米膦酸二钠是一种通过破骨细胞介导的骨吸收抑制剂，已被用于治疗继发于恶性肿瘤和慢性肾衰竭的慢性高钙血症。我们报告了帕米膦酸用于治疗医源性维生素D中毒继发的急性重度高钙血症的情况。
一名77岁的女性养老院居民在6天内每天意外服用50000单位的口服维生素D。患者出现嗜睡、腹痛和呕吐。患者最初的血清钙浓度为5.25 mmol/L（21 mg/dL）。患者最初接受了补液和呋塞米治疗，但出现了充血性心力衰竭。使用了帕米膦酸，治疗后24小时血钙浓度恢复正常。
我们报告了一例使用帕米膦酸治疗急性维生素D中毒继发的显著高钙血症的病例。尽管充血性心力衰竭的证据明显，但避免了透析，且无明显后遗症。对于急性维生素D中毒继发高钙血症的患者，应考虑使用帕米膦酸治疗。
