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A case report published in Reactions Weekly describes a female patient with cardio-facio-cutaneous syndrome (CFC) who experienced treatment failure with various medications. The patient had been suffering from inflammatory dermatitis since the age of 2 and had tried topical and systemic therapies including acitretin, methotrexate, ustekinumab, steroids, calcineurin inhibitors, and vitamin D analogues. Despite these treatments, the patient did not experience improvement until she started receiving off-label dupilumab injections every 15 days. After three months, her skin lesions and pruritus significantly improved, allowing her to stop using steroids. The treatment has been ongoing for 24 months with sustained improvement. [Extracted from the article]

A 78-year-old woman developed hypercalcemia while being treated for osteoporosis with aspartic-acid, elcatonin, and calcitriol. She had a history of osteotomy and lived in a cadmium-exposed area. Her treatment was stopped and she started taking alendronic-acid instead. However, she later developed renal failure and was diagnosed with itai-itai disease. Her condition deteriorated and she died of renal failure at the age of 89. [Extracted from the article]

A case report describes the toxicities, drug misuse, drug overdose, and lack of efficacy in a 4-year-old boy who experienced various health issues. The boy was hospitalized with symptoms such as vomiting, hyporexia, general malaise, bilateral parenchymal inflammatory nephropathy, knee pain, weight loss, and arterial hypertension. It was discovered that the boy had intentionally misused and overdosed on colecalciferol, leading to drug intoxication. He also experienced hypophosphataemia due to treatment with pamidronic-acid. Despite receiving amlodipine for arterial hypertension, the boy did not experience improvement and was switched to methyldopa. With treatment, the boy's symptoms resolved, and he was discharged in a healthy condition. [Extracted from the article]

A case report published in Reactions Weekly describes a woman in her 50s who exhibited lack of efficacy during treatment for autoimmune connective tissue disorder and hypophosphataemia. The woman received prednisolone and hydroxychloroquine, but no improvement was noted and the medications were tapered off. She also received alfacalcidol for hypophosphataemia, but it was eventually switched with calcitriol due to lack of efficacy. After undergoing surgery and treatment, the woman showed signs of recovery and improvement in her condition. [Extracted from the article]

A 92-year-old woman experienced hypercalcemia after overdosing on colecalciferol while being treated for osteoporosis. She had a history of dementia, heart failure, hypothyroidism, and osteoporosis. The woman presented with altered mental status, constipation, and limited orientation. Lab results showed elevated calcium levels and low levels of PTH. After discontinuing colecalciferol and receiving IV fluids, the woman's calcium levels improved. She was eventually discharged with normal calcium levels. [Extracted from the article]

A 34-year-old man from Afghanistan developed increased levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) while being treated with carbamazepine for epileptic seizures. He also had severe hypocalcaemia and hypoparathyroidism, and was subsequently diagnosed with Fahr syndrome. The man was admitted to a critical care unit and treated with various medications. After treatment, his liver enzyme levels returned to normal and his symptoms resolved. However, he did not attend his follow-up appointments and was lost to further evaluation. [Extracted from the article]

A 72-year-old woman experienced delayed hypercalcaemia while being treated for osteoporosis with teriparatide and calcium/colecalciferol. She had a history of hypertension, hyperlipidaemia, and hepatitis C, and was taking several medications including aspirin, bisoprolol, amlodipine, rosuvastatin, and calcium/colecalciferol. After three months of treatment, she was admitted to the hospital with mild dehydration and high serum calcium levels. The teriparatide and calcium/colecalciferol were discontinued, and she received intravenous fluids. Her calcium levels eventually returned to normal after several days. Teriparatide was restarted but caused hypercalcaemia again, so it was switched to denosumab, which resolved her condition. [Extracted from the article]

A 61-year-old woman experienced hypercalcemia and acute kidney injury while being treated with alfacalcidol and calcium/colecalciferol for irreversible hypoparathyroidism. She had a history of hypertension and total thyroidectomy. Prior to admission, she was taking hormone replacement therapy and managing her bone biochemistry and hypertension with various medications. The woman was treated with intravenous fluids and bisphosphonates, and her calcium levels returned to normal. It was determined that the hypercalcemia was caused by the alfacalcidol and calcium/colecalciferol. [Extracted from the article]

A 58-year-old woman experienced a hypercalcaemic crisis after misusing colecalciferol. She presented with altered mental status and somnolence, and laboratory tests revealed severe hypercalcaemia and other abnormalities. The woman underwent emergent haemodialysis and showed gradual improvement in her condition. She reported taking over-the-counter colecalciferol at a high dosage for several months. Her calcium levels and renal function improved, but her 25-hydroxyvitamin D levels remained elevated. [Extracted from the article]

A 58-year-old woman experienced a hypercalcaemic crisis after misusing colecalciferol. She presented with altered mental status and somnolence, and laboratory tests revealed severe hypercalcaemia and other abnormalities. The woman underwent emergent haemodialysis and showed gradual improvement in her condition. She reported taking over-the-counter colecalciferol at a high dosage for several months. Her calcium levels and renal function improved, but her 25-hydroxyvitamin D levels remained elevated. [Extracted from the article]

A 41-year-old man with pancreatic neuroendocrine tumor received treatment with calcium, colecalciferol, and calcitriol for hypocalcaemia. Despite the treatment, he remained hypocalcaemic, indicating a lack of efficacy. The man had previously undergone chemotherapy, radiation, brain surgery, and thoracentesis for his condition. Unfortunately, his condition worsened, and he ultimately died due to hypocalcaemia. [Extracted from the article]

This article from Reactions Weekly discusses two case studies of women who developed multiple lipomatoses while being treated with rosiglitazone or pioglitazone for diabetes. The first patient, a 33-year-old woman with familial partial lipodystrophy, developed lipomatoses in various areas of her body despite undergoing surgeries. The second patient, a 43-year-old woman with the same condition, noticed lipomatous deposits after taking pioglitazone for a year. In both cases, the lipomatoses were considered to be a result of the medication. [Extracted from the article]

A 58-year-old man experienced treatment failure and mild hypercalcemia while being treated with colecalciferol for vitamin D deficiency. The man had a history of sleep apnea, hypertension, and hypogonadism, and presented with symptoms of muscle cramps, fatigue, and joint pain. Despite aggressive supplementation with colecalciferol and the addition of calcitriol, the man's vitamin D levels did not normalize. Calcitriol was discontinued due to the mild hypercalcemia. Follow-up tests after five years showed similar results. [Extracted from the article]

This article discusses two case reports of patients with autosomal recessive hypophosphatemic rickets type 1 (ARHR1) who exhibited lack of efficacy during treatment with colecalciferol and calcitriol. One patient also developed drug intolerance during treatment with cinacalcet. Various examinations were performed on both patients, and they were subsequently treated with off-label burosumab, which showed improvement in their condition without any adverse effects. These case reports highlight the potential lack of efficacy and drug intolerance associated with certain treatments for ARHR1, and suggest that burosumab may be a viable alternative. [Extracted from the article]

A 77-year-old woman experienced hypervitaminosis-D and hypercalcaemia while being treated with colecalciferol for vitamin-D deficiency. She mistakenly stopped taking hydrocortisone, which was prescribed to treat the hypercalcaemia. The woman had a history of vitamin D deficiency and had previously been admitted for hypercalcaemia caused by lithium use. She was treated with hydration, calcitonin, and prednisone, and her calcium levels improved. However, due to a misunderstanding, she stopped taking hydrocortisone, resulting in increased calcium levels. After restarting hydrocortisone, her calcium levels improved again. The hypervitaminosis-D and hypercalcaemia were attributed to the colecalciferol. [Extracted from the article]

Author InformationAn event is serious (based on the ICH definition) when the patient outcome is: Drug overdose• * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important eventA 29-year-old man developed colecalciferol toxicity following accidental colecalciferol overdose. [Extracted from the article]

Author InformationAn event is serious (based on the ICH definition) when the patient outcome is:Drug overdose• * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important eventA 57-year-old man developed weakness, constipation, polydipsia, polyuria, hypercalcaemia secondary to Vitamin D toxicity during treatment with Vitamin-D and colecalciferol. Additionally, he exhibited drug overdose with colecalciferol[indications, routes , duration of treatments to reaction onsets not stated; not all outcomes stated]. [Extracted from the article]

A 62-year-old woman experienced an atypical femoral fracture while being treated with alendronic-acid for osteoporosis. She later showed a lack of efficacy while being treated with calcium, colecalciferol, and raloxifene for osteoporosis. The woman's treatment with alendronic-acid was stopped, and she started receiving raloxifene, calcium, and colecalciferol. After 14 years, she developed various musculoskeletal complaints unrelated to her initial fracture and presented with new onset thigh and groin pain. Imaging revealed incomplete atypical femoral fractures in both femurs, and she underwent surgery with complete resolution of pain. [Extracted from the article]

A 62-year-old woman with a history of diabetes and hypertension experienced a lack of efficacy when treated with ibuprofen and codeine phosphate for SAPHO syndrome. She had previously undergone lumbar spine surgery and thyroid surgery. After the initial surgery, her symptoms improved but later recurred. The woman's pain did not respond to ibuprofen and codeine phosphate, so she was switched to other medications, including loxoprofen, cobamamide, calcium carbonate, and colecalciferol, which provided some relief. After being diagnosed with SAPHO syndrome, she was prescribed sulfasalazine, adalimumab, pregabalin, and tramadol, which resulted in complete resolution of her pain. [Extracted from the article]

After 15 days of hydroxychloroquine initiation, she developed hydroxychloroquine induced AGEP. After 20 days of hydroxychloroquine, she developed hydroxychloroquine induced AGEP. After 7 days of hydroxychloroquine initiation, she developed hydroxychloroquine induced AGEP. [Extracted from the article]

Reference 1 Unauthorized prescription and controlled drugs seized from two natural food stores in Sudbury, Ontario, because they may pose serious health risks Internet Document: 20 Feb 2023. Health Canada has seized unauthorised health products from two natural food stores (Paris Natural Foods, and Durham Natural Foods) in Sudbury, Ontario, because the products are labelled to contain prescription or controlled drugs which may pose serious health risks. The unauthorised products include prescription-strength vitamin D3 supplements (Paris Natural Foods Vitamin D3 [4000IU or 10 000IU]), hormone capsules (Paris Natural Foods DHEA [dehydroepiandrosterone]; promoted as a workout supplement), hormone cream (Natrix Pharmaceuticals Dioscorene Natural Progesterone Cream; promoted as hormone replacement therapy), and a sexual enhancement product (Paragon Alternative Medicine Clinic Amore Exotic Herbal Formula). [Extracted from the article]

However, her 25-OH-vitamin D3 concentration remained elevated at 374 nmol/L. During follow-up, there was a increase in plasma calcium and 25-OH-vitamin D3 concentrations. He total and ionised plasma concentrations of 4 mmol/L and 2.19 mmol/L, respectively, along with elevated plasma concentration of 25-OH-vitamin D3 of 1289 nmol/L and normal concentrations of 1, 25-OH-vitamin D3 of 178 pmol/L. He increased plasma creatinine concentration of 193 µmol/L, indicated acute kidney injury. He was discharged with normal 1, 25-OH-vitamin D3 and plasma calcium concentrations, while plasma 25-OH-vitamin D3 concentration was still elevated. [Extracted from the article]

B Author Information b An event is serious (based on the ICH definition) when the patient outcome is: * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important event A 59-year-old woman developed hypercalcaemia due to drug toxicity during treatment with colecalciferol for Sjogren's syndrome. During admission, an abdominal ultrasound showed mild hepato-splenomegaly, multiple hypoechoic hepatic nodules and multiple sub centimetric hypo-anechoic splenic nodules. [Extracted from the article]

Further investigations revealed low intact parathyroid hormone (PTH), undetectable PTH related peptide but elevated 1,25 (OH)2 Vitamin D 146 pg/mL. B Author Information b An event is serious (based on the ICH definition) when the patient outcome is: * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important event A 31-year-old man developed hypercalcemia and granulomatous disease following abuse of off-label colecalciferol used to increase strength and muscle mass [ I time to reactions onset not stated; not all outcomes stated i ]. [Extracted from the article]

She had toxic hypervitaminosis D with vitamin D resistant rickets also known as hypophosphatemic rickets. B Author Information b An event is serious (based on the ICH definition) when the patient outcome is: Drug overdose * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important event A 2-year-old girl developed hypervitaminosis-D and vitamin D toxicity following colecalciferol and ergocalciferol overdose [ I not all routes stated; dosages not stated i ]. [Extracted from the article]

However, her depression symptoms persisted, despite 1 month of treatment with mirtazapine and fluoxetine. B Author Information b An event is serious (based on the ICH definition) when the patient outcome is: * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important event A 32-year-old woman exhibited lack of efficacy with fluoxetine and mirtazapine, while being treated for depression and with duloxetine, while being treated for fibromyalgia [ I routes not stated i ]. The woman was presented with joylessness, unhappiness, resultant crying jag, head-neck pain and numbness and pain at left arm and leg. [Extracted from the article]

Hence, elcatonin 80 U/day was added to the ongoing furosemide therapy for three days; however, despite the combination treatment, no improvement was noted indicating lack of efficacy for the furosemide and elcatonin therapy. He also exhibited lack of efficacy during treatment with elcatonin and furosemide for the hypercalcaemia [ I routes and duration of treatment to reaction onset not stated i ]. B Author Information b An event is serious (based on the ICH definition) when the patient outcome is: * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important event A 62-year-old man developed hypercalcaemia and acute kidney injury while receiving supplementation treatment with colecalciferol. [Extracted from the article]

She started receiving IV sodium chloride [saline] 3 L/day along with unspecified hydration therapy, which failed to improve ionised calcium level. B Author Information b An event is serious (based on the ICH definition) when the patient outcome is: * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important event A 26-year-old woman exhibited treatment failure while being treated with sodium chloride for hypercalcaemia during third trimester of pregnancy. [Extracted from the article]

Initially the girl was treated with furosemide maintenance dose of 1 mg/kg/dose every 8 hour and IV sodium-chloride [saline fluid] bolus for hypercalcaemia. B Author Information b An event is serious (based on the ICH definition) when the patient outcome is: * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important event * Drug overdose A 2-months-old girl developed hypercalcaemia following an exposure to overdose of colecalciferol via breast milk. [Extracted from the article]

During admission, his blood test revealed stage 3 acute kidney injury (AKI) with elevated creatinine and uraemia. During admission, his blood tests revealed stage 3 AKI with elevated creatinine and uraemia. [Extracted from the article]

B Author Information b An event is serious (based on the ICH definition) when the patient outcome is: * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important event A 43-year-old man developed severe hypophosphataemia during treatment with denosumab for osteoporosis. He was treated with unspecified IV and high dose oral replacements, calcium citrate, calcitriol and colecalciferol [cholecalciferol]. Later, examinations revealed hypophosphaturia, raised PTH, low calcitriol and high fibroblast growth factor-23 levels. [Extracted from the article]

B Author Information b An event is serious (based on the ICH definition) when the patient outcome is: * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important event A 68-year-old man developed hypercalcaemia during treatment with colecalciferol as a vitamin-D supplementation. At the time of discharge on day 16, serum corrected calcium and creatinine had improved. After 1 month of cyclophosphamide and tapering prednisolone, his creatinine level showed further improvement. [Extracted from the article]

However, after detailed investigations, she was diagnosed with stage 4 invasive lobular breast carcinoma. Gastric metastasis before diagnosis of primary invasive lobular breast carcinoma: a rare case presentation from Pakistan. Over the period of time, she survived her extensively metastatic stage IV of invasive lobular breast carcinoma for over one year. [Extracted from the article]

Her oral levothyroxine-sodium 1000µg loading test showed a significant increase in free thyroxine and a decrease in TSH level indicating pseudomalabsorption, but the other mechanism mentioned above may contribute to refractory hypothyroidism. She underwent levothyroxine-sodium loading test with oral levothyroxine-sodium 1000 mcg and her free thyroxine increased and TSH decreased indicating pseudomalabsorption, but the other mechanism mentioned above may contribute to refractory hypothyroidism. [Extracted from the article]