title: Vitamin d toxicity in adults: a case series from an area with endemic hypovitaminosis d.
abstract: Vitamin D deficiency state is endemic to the Kashmir valley of the Indian subcontinent. Physicians often treat patients with high doses of vitamin D for various ailments and on occasion the prescribed doses far exceed the requirements of the patients. Ten cases of hypercalcemia due to vitamin D intoxication are presented with features of vomiting, polyuria, polydipsia, encephalopathy and renal dysfunction. All the patients had demonstrable hypercalcemia and vitamin D levels were high in nine of the 10 cases. The patients had received high doses of vitamin D and no other cause of hypercalcemia was identified. Treatment of hypercalcemia resulted in clinical recovery in nine cases. We conclude that hypervitaminosis D must be considered in the differential diagnosis of patients with hypercalcemia in endemically vitamin D deficient areas. A careful history and appropriate biochemical investigation will unravel the diagnosis in most of the cases.
authors: Department of Internal Medicine, SheriKashmir Institute of Medical Sciences, Soura, Srinagar 190011, J&K, India.
authors: Parvaiz A
authors: PA
authors: Koul
authors: Sheikh Hilal
authors: SH
authors: Ahmad
authors: Feroze
authors: F
authors: Ahmad
authors: Rafi A
authors: RA
authors: Jan
authors: S U
authors: SU
authors: Shah
authors: Umar H
authors: UH
authors: Khan