Vitamin D Toxicity Managed with Peritoneal Dialysis.
Publication/Presentation Date
1-1-2021
Abstract
Vitamin D deficiency is a global health issue that afflicts more than one billion children and adults worldwide. Vitamin D supplementation has increased over the years, whether through medical prescriptions, over-the-counter, or online purchasing. This is driven by a more recognized association between vitamin D sufficiency status and lower risk of cancer. In addition, more recently, it is used as a potential prophylactic and treatment for COVID-19 infection. This can lead to toxicity from overingestion. While rare, it has been reported in the literature. In this case report, we present a 75-year-old man with severe hypercalcemia secondary to vitamin D toxicity managed with peritoneal dialysis. He presented with biochemical evidence of hypercalcemia, acute kidney injury, and pancreatitis. Workup for his hypercalcemia led to the diagnosis of vitamin D toxicity as shown by a level greater than 200 ng/dL (Ref: 20-50 ng/mL) was confirmed by liquid chromatography-mass spectroscopy. Cornerstone medical management of hypercalcemia was provided which included aggressive intravenous fluid hydration, intravenous diuretics, calcitonin, bisphosphonate, and corticosteroid therapy. At every interruption of therapy, calcium levels trended upward. A thorough literature review yielded the finding of a sole case report from 1966 presented at the Third International Congress of Nephrology, in which peritoneal dialysis was used in the management of vitamin D toxicity and hypercalcemia. This modality is established to cause vitamin D deficiency. In collaboration with the nephrology team, 10 sessions of peritoneal dialysis were undertaken with resolution of hypercalcemia and downtrend in 25-hydroxyvitamin D levels as measured by dilution.
Volume
2021
First Page
9912068
Last Page
9912068
ISSN
2090-6501
Published In/Presented At
Feghali, K., Papamarkakis, K., Clark, J., Malhotra, N., Stoddart, L., & Osakwe, I. (2021). Vitamin D Toxicity Managed with Peritoneal Dialysis. Case reports in endocrinology, 2021, 9912068. https://doi.org/10.1155/2021/9912068
Disciplines
Medicine and Health Sciences
PubMedID
34258083
Department(s)
Department of Medicine
Document Type
Article