Life-threatening complications of vitamin D intoxication due to over-the-counter supplements
Life-threatening complications of vitamin D intoxication due to over-the-counter supplements
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DOI：
10.3109/15563650.2010.486382
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发表时间：
2010-06-01
影响因子：
3.3
通讯作者：
Nieboer, Peter
中科院分区：
文献类型：
--
作者：
Kaptein, Sara;Risselada, Arne J.;Nieboer, Peter
导论. 90%的高钙血症病例是由原发性甲状旁腺功能亢进或恶性肿瘤引起的。较不常见的原因是肉芽肿性疾病、药物引起的疾病和中毒。病例报告。我们介绍了两名妇女由于摄入维生素D浓缩补充剂而患上危及生命的高钙血症，结果是非处方膳食补充剂标签上所述的100- 1000倍。实验室分析显示离子钙水平分别为4.00（16.00）和4.56 mmol/L（18.24 mg/dL），维生素D-25浓度分别为1，372和644 nmol/L。除了一般症状的高钙血症患者，难治性癫痫持续状态的情况下，纠正血清钙水平，并在需要长期ICU治疗，描述。结论所提供病例的初始用药史未显示使用非处方补充剂，这强调了对（非）处方药物进行全面评价的重要性。此外，这些补充剂可能含有比标签所述更高水平的维生素D。因此，高钙血症可能是危及生命的并发症的根本原因，包括有充分记录的难治性癫痫持续状态。
Introduction. Ninety percent of hypercalcemic cases are caused by primary hyperparathyroidism or malignancy. Less frequent causes are granulomatous diseases, drug-induced diseases, and intoxications. Case report. We present two women with life-threatening hypercalcemia due to the intake of vitamin D-concentrated supplements, which turned out to be 100-1,000 times higher than stated on the label of over-the-counter dietary supplements. Laboratory analysis revealed ionized calcium levels of 4.00 (16.00) and 4.56 mmol/L (18.24 mg/dL) with vitamin D-25 concentrations of 1,372 and 644 nmol/L, respectively. Apart from a patient with general symptoms of hypercalcemia, a case of refractory status epilepticus after correction of serum calcium levels, and in need of prolonged ICU treatment, is described. Conclusion. Initial drug-taking history in the presented cases did not reveal the use of over-the-counter supplements, which underlines the importance of a thorough evaluation of (non-) prescribed medication. Moreover, these supplements may contain higher levels of vitamin D than the label states. As a result, hypercalcemia may be an underlying cause for life-threatening complications, including a well-documented refractory status epilepticus.