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High-dose Vitamin D Supplementation Precipitating Hypercalcemic Crisis in Granulomatous Disorders.
- Source :
-
Indian Journal of Endocrinology & Metabolism . Nov/Dec2017, Vol. 21 Issue 6, p815-819. 5p. - Publication Year :
- 2017
-
Abstract
- Background: Vitamin D supplementation precipitating hypercalcemic crisis is often the first manifestation in patients with granulomatous disorders. Methods: We report our experience on patients presenting with hypercalcemic crisis due to granulomatous disorder and the role of Vitamin D supplementation in the precipitation of hypercalcemic crisis in them. Results: The study included five patients with granulomatous disorders who presented with hypercalcemic crisis. All patients initially presented with nonspecific constitutional symptoms to other health-care centers to receive high-dose Vitamin D supplementation (60,000 U/week or 600,000 U intramuscular single dose). All of these patients presented with hypercalcemic crisis (serum calcium: 16.04 ± 0.3 mg/dl) to our centers after a period of 32.8 ± 9.62 days. Three patients were diagnosed to have sarcoidosis, and two were diagnosed to have tuberculosis. All five patients had parathyroid hormone-independent hypercalcemia with elevated serum 1,25-dihydroxy Vitamin D. Serum angiotensin-converting enzyme level was elevated in all the three patients with sarcoidosis. Fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography was performed in two patients with sarcoidosis which demonstrated diffusely increased tracer uptake in liver. In these two patients, liver biopsy confirmed the diagnosis. Conclusions: High-dose Vitamin D supplementation is most often the underlying cause of hypercalcemic crisis in patients with granulomatous disorders. Hence, high-dose Vitamin D supplementation should be used judiciously. [ABSTRACT FROM AUTHOR]
- Subjects :
- *HYPERCALCEMIA
*PHYSIOLOGICAL effects of vitamin D
*CHRONIC granulomatous disease
Subjects
Details
- Language :
- English
- ISSN :
- 22308210
- Volume :
- 21
- Issue :
- 6
- Database :
- Academic Search Index
- Journal :
- Indian Journal of Endocrinology & Metabolism
- Publication Type :
- Academic Journal
- Accession number :
- 126459534
- Full Text :
- https://doi.org/10.4103/ijem.IJEM_577_16