[Hypercalcemia due to chronic vitamin A use by an elderly patient with renal insufficiency].
An 86-year-old woman presented with anorexia, thirst and nycturia. Laboratory results revealed a hypercalcaemia with renal failure. The patient used 1-6 vitamin A-D tablets daily (1 tablet contains 600 IU retinol palmitate and 200 IU cholecalciferol). The diagnosis was: hypercalcaemia due to chronic vitamin A ingestion. This diagnosis was supported by the finding of the elevated vitamin A concentration in the patient's serum and the exclusion of other causes of hypercalcaemia. In chronic vitamin A ingestion risk factors for vitamin A toxicity are age, body weight and renal insufficiency. The hypercalcaemia caused by chronic vitamin A ingestion is explained through the up-regulation of osteoclasts by retinol metabolites.
Klinisch-Chemisch Laboratorium, Diaconessenhuis, Postbus 9650, 2300 RD Leiden.
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Beijer
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Planken
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000855:Anorexia / Q000209:etiology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000139:chemically induced*; D006986:Hypervitaminosis A / Q000150:complications* / Q000175:diagnosis*; D007676:Kidney Failure, Chronic / Q000150:complications*; D014555:Urination Disorders / Q000209:etiology; D014801:Vitamin A / Q000009:adverse effects* / Q000097:blood; D015431:Weight Loss
D014801:Vitamin A