Calcinosis and metastatic calcification due to vitamin D intoxication. A case report and review.
Vitamin D, a fat-soluble vitamin, can be associated with significant morbidity when prescribed in large doses. We describe a hypoparathyroid patient with vitamin D intoxication who developed painful periarticular calcinosis, nephrocalcinosis with hypertension and chronic renal failure in addition to band keratopathy and hearing loss. He was treated with combination therapy including prednisone, phosphate-binding antacid, phenytoin and disodium etidronate. After 20 months of follow-up there was a significant reduction of periarticular calcinosis, but no improvement in renal function, band keratopathy or hearing loss and possible calcification of the ossicles. The clinicopathologic features of metastatic calcification and the various treatment modalities are reviewed.
Allen
S H
SH
Cosmopolitan International Diabetes Center, University of Missouri, Columbia School of Medicine.
Shah
J H
JH
D000328:Adult; D000536:Aluminum Hydroxide / Q000627:therapeutic use; D002114:Calcinosis / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D004872:Ergocalciferols / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D012968:Etidronic Acid / Q000627:therapeutic use; D006801:Humans; D007592:Joint Diseases / Q000139:chemically induced; D008297:Male; D009397:Nephrocalcinosis / Q000139:chemically induced; D010672:Phenytoin / Q000627:therapeutic use; D011241:Prednisone / Q000627:therapeutic use
D004872:Ergocalciferols; D000536:Aluminum Hydroxide; D010672:Phenytoin; D012968:Etidronic Acid; D011241:Prednisone