Iatrogenic vitamin D overdose resulting in acute pancreatitis with acute kidney injury

Abstract

Vitamin D deficiency is prevalent worldwide. Most of patients with mild vitamin D deficiency are often over-treated with higher dose of vitamin D supplementation than required resulting in toxic levels of vitamin D. While correcting, one should regularly look for adverse effects of overcorrection resulting in hypervitaminosis D. We discuss here a similar case of 34-year-old woman who presented to us with persistent acute abdominal pain since 48 hours and oliguria since 24 hours. She was found to have hypercalcemia induced pancreatitis with acute kidney injury. Cause of hypercalcemia was found to be hypervitaminosis D. Thereafter, she was treated with aggressive hydration and diuretics, and required calcitonin for control of hypercalcemia to which she responded. Thus we suggest that in any patient who presents with hypercalcemia with low parathyroid levels, hypervitaminosis D should be suspected. Primary care physicians should be alerted of such cases, to avoid overcorrection of vitamin D. Mild vitamin D deficiency should be initially corrected with adequate sunlight exposure and fortified/enriched vitamin D food supplements.

Keywords: Hypercalcemia, Hypervitaminosis D, Acute kidney injury, Acute pancreatitis