title: Hypercalcemia, hypervitaminosis A and 3-epi-25-OH-D3 levels after consumption of an "over the counter" vitamin D remedy. a case report.
abstract: Intoxication from vitamin D supplements has been rarely reported but, nowadays, it occurs more frequently. 3-epi-25-OH-D(3) is highly prevalent in adults and it is considered of biological relevance. We report a case of vitamin D toxicity with hypercalcemia, acute renal failure and hypervitaminosis A after consuming an over-the-counter vitamin D supplement. Our data suggest that the contribution of 3-epi-25-OH-D(3) is not altered during vitamin D toxicity, although the serum levels of 25-OH-D(3) and 3-epi-25-OH-D(3) may display a different rate of clearance. The patient also displayed hypervitaminosis A unrelated to diet, possibly caused by renal failure related to the hypercalcemia induced by vitamin D toxicity. Because of the increasing use of over-the-counter vitamin D supplements and the potential iatrogenic hypercalcemia related to hypervitaminosis A, the present case highlights the importance of evaluating both the use of (non-) prescribed medication and vitamin A status during vitamin D toxicity.
authors.affiliation: Unidad de Vitaminas, Servicio de Bioquímica Clínica, Hospital Universitario Puerta de Hierro, Majadahonda (Madrid), Spain. fgranado.hpth@salud.madrid.org
authors.forename: F
authors.initials: F
authors.lastname: Granado-Lorencio
authors.forename: E
authors.initials: E
authors.lastname: Rubio
authors.forename: I
authors.initials: I
authors.lastname: Blanco-Navarro
authors.forename: B
authors.initials: B
authors.lastname: Pérez-Sacristán
authors.forename: R
authors.initials: R
authors.lastname: Rodríguez-Pena
authors.forename: F J
authors.initials: FJ
authors.lastname: García López
mesh_terms: D015652:25-Hydroxyvitamin D 2 / Q000097:blood; D058186:Acute Kidney Injury / Q000139:chemically induced; D002112:Calcifediol / Q000097:blood*; D002851:Chromatography, High Pressure Liquid; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000097:blood / Q000139:chemically induced*; D006986:Hypervitaminosis A / Q000097:blood / Q000139:chemically induced*; D019300:Medical Errors; D008875:Middle Aged; D011786:Quality Control; D014801:Vitamin A / Q000097:blood; D014807:Vitamin D / Q000009:adverse effects*; D014815:Vitamins / Q000009:adverse effects*
chemical_list: D014815:Vitamins; D014801:Vitamin A; D014807:Vitamin D; D015652:25-Hydroxyvitamin D 2; D002112:Calcifediol