Hypervitaminosis D in Kashmiri Population: A Case Series of 11 Patients

SSRG International Journal of Medical Science (SSRG-IJMS)
© 2016 by SSRG - IJMS Journal
Volume-3 Issue-2
Year of Publication : 2016
Authors : Sulaiman Sath, S.Asif Rafiq Shah, Syed Nadeem Rafiq, Irtifa Jeelani
  10.14445/23939117/IJMS-V3I2P101
pdf
Citation:
      Sulaiman Sath, S.Asif Rafiq Shah, Syed Nadeem Rafiq, Irtifa Jeelani "Hypervitaminosis D in Kashmiri Population: A Case Series of 11 Patients", SSRG International Journal of Medical Science (SSRG - IJMS), V3(2),1-6 February 2016. ISSN:2393 - 9117. www.internationaljournalssrg.org/IJMS/index.html. Published by : Seventh Sense Research Group.
Abstract:
      Vitamin D,although safe in usual doses can be toxic in higher doses and can affect different body organs due to hypercalcemia.As vitamin D deficiency is quiet common in Kashmir,so people either by self medication or as prescribed by clinicians take vitamin D empirically leading to hypervitaminosis D.We undertook a similar study of 11 cases of hypervitaminosis D who developed symptoms of hypercalcemia due to excess intake vitamin D supplements for back pains, osteoarthritis, osteoporosis, diabetes, etc. From this study we finally concluded that before prescribing vitamin D supplements, we should properly look into the background history of the patient along with biochemical parameters to know the status of vitamin D so that toxicity is prevented.
References:
1.Parfitt AM, Gallagher JC, Heaney RP et al (1982) Vitamin D and bone health in the elderly. Am J Clin Nutr 36:1014–1031.
2. Holick M (2002) Vitamin D: the underappreciated D-lightful hormone that is important for skeletal and cellular health. Curr Opin Endocrinol Diabetes Obes 9:87–98.
3. Holick MF (1999) Evolution, biologic functions, and recommended dietary allowance for vitamin D.In:Holick MF (ed) Vitamin D: physiology, molecular biology and clinical applications. Humana Press, Totowa, New Jersey, pp1–16.
4. Rizzoli R, Bonjour J (2004) Dietary protein and bone health.J Bone Miner Res 19:527.
5. Lips P (2001) Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications. Endocr Rev 22:477–501.
6. Holick MF (1990) Vitamin D and the skin: photobiology, physiology and therapeutic efficacy for psoriasis. In: Heersche JNM, Kanis JA (eds) Bone and mineral research. Elsevier, Amsterdam, pp 313–366.
7. Garland CF, Comstock GW, Garland FC et al (1989) Serum 25- hydroxyvitamin D and colon cancer—8 year prospective study. Lancet 2:1176–1178.
8. Garland FC, Garland CF, Gorham ED, Young JF (1990).Geographic variation in breast cancer mortality in the United States: a hypothesis involving exposure to solar radiation. Prev Med 19:614–622.
9. Hernan MA, Olek MJ, Ascherio A (1999) Geographic variation of MS incidence in two prospective studies of US women. Neurology 53:1711–1718.
10. Pittas AG, Harris SS, Stark PC, Dawson-Hughes B (2007) The effects of calcium and vitamin D supplementation on blood glucose and markers of inflammation in nondiabetic adults. Diabetes Care 30:980–986.
11. Rostand SG (1979) Ultraviolet light may contribute to geographic and racial blood pressure differences. Hypertension.30:150–156.
12. Boland R (1986) Role of vitamin D in skeletal muscle function. Endocr Rev 7:434–448.
13. Bischoff HA, Stahelin HB, Urscheler N et al (1999) Muscle strength in the elderly: its relation to vitamin D metabolites. Arch Phys Med Rehabil 80:54–58.
14. Robert MR,Paolo MS. Vitamin and trace mineral deficiency and excess.Pp.594-605.In Harrison’s principles of internal medicine. Volume 1, 18th edition. Edited by Longo DL,Fauci AS, Kasper DL,Hauser SL, Jameson JL,Loscalzo J.New York:Mc Graw Hill,2012.
15. Petr JB Asthma Pp 2012-2155.In Harrison’s principles of internal medicine. Volume 2, 18th edition. Edited by Longo DL,Fauci AS, Kasper DL,Hauser SL, Jameson JL,Loscalzo J.New York:Mc Graw Hill,2012.
16. Mizrachi CB et al.Vitamin D deficiency.Pp.185-199.In the Washington manual endocrinology subspeciality consult, 2nd edition.Henderson KE,Baranski TJ,Bicke PE,Clutter WE,Mc Gill JB.St.Louis:Lipppincott Williams and Wilkins,2009.
17. John TP,Jr Harald J.Disorders of the parathyroid gland and calcium homeostasis. Pp 3096-3120.In Harrison’s principles of internal medicine. Volume 2, 18th edition. Edited by Longo DL,Fauci AS, Kasper DL,Hauser SL, Jameson JL,Loscalzo J.New York:Mc Graw Hill,2012.
18. Bischoff-Ferrari HA et al.Fracture prevention with vitamin D supplementation: A meta-analysis of randomized controlled trials. JAMA 2005,293:2257-64.
19. Brighurst FR et al.Bone and mineral metabolism in health and disease.Pp 2365-77. In Harrison’s principles of internal medicine. Volume 2, 17th edition. Edited by Longo DL,Fauci AS, Kasper DL,Hauser SL,Jameson JL,Loscalzo J.New York: Mc Graw Hill,2008.
20. Jones G. Vitamin D in the 21st century: An Update- Pharmacokinetics of vitamin D toxicity. Am J Clin Nutr 2008; 88:582S-586S.
21. Hathcock JN, Shao A, Vieth R, Heaney R. ―Risk assessment for vitamin D. Am J Clin Nutr 2007;85:6-18
22. Dobnig H,Pilz S,Scharnagl H,et al.Independent association of low serum 25- Hydroxy vitamin D and 1,25 –Hydoxy vitamin D levels with all cause and cardiovascular mortality .Arch Intern Med 2008;168:1340-9.
23. Bouillon R, Van Schoor NM, Gielen E, Boonen S, Mathieu C, et al. (2013) Optimal vitamin D status: a critical analysis on the basis of evidence-based medicine. J Clin Endocrinol Metab 98: E1283-E1304.
24. Khazai N, Judd SE, Tangpricha V. Calcium and vitamin D: skeletal and extra skeletal health. Curr Rheumatol Rep 2008; 10:110–117.
25. Joshi R. Hypercalcemia due to Hypervitaminosis D: report of seven patients. J Trop Pediatr 2009;55:396-398.
26. Ross AC, Manson JE, Abrams SA, Aloia JF, Brannon PM, et al. (2011) The 2011 Report on Dietary Reference Intakes for Calcium and Vitamin D from the Institute of Medicine: What clinicians need to know. J Clin Endocrinol Metab 96: 53-58.
27. Blank S, Scanlon KS, Sinks TH, Lett S, Falk H (1995) An outbreak of hypervitaminosis D associated with the overfortification of milk from a home-delivery dairy. Am J Public Health 85: 656-659.
28. Nussey S, Whitehead S (2001) Endocrinology: An Integrated Approach. Oxford: BIOS Scientific Publishers.
29. Lodh M, Mukhopadhyay R, Jajodia N, Sen D, Roy A (2015) Adult Hypervitaminosis D-A Case Series. Int J Endocr Metab Disord 1(3): doi http:// dx.doi.org/10.16966/2380-548X.111.
30. Pandita KK, Pandita S, Hassan T. Toxic beef bone soup.Clinical cases and bone metabolism 2011;8(2):43-44. 31. Ozkan B, Hatun S, Bereket A (2012) Vitamin D intoxication. Turk J Pediatr 54: 93-98.
32. Francis RM, Aspray TJ, Bowring CE, Fraser WD, Gittoes NJ, et al. (2015) National Osteoporosis Society practical clinical guideline on vitamin D and bone health. Maturitas 80: 119-121.
33. McKenna MJ, Murray BF (2013) Vitamin D dose response is underestimated by Endocrine Society’s Clinical Practice Guideline. Endocr Connect 2: 87-95.
34. Rosen CJ, Abrams SA, Aloia JF, Brannon PM, Clinton SK, et al. (2012) IOM Committee Members Respond to Endocrine Society Vitamin D Guideline. J Clin Endocrinol Metabol 97: 1146- 1152.
Key Words:
      Vitamin D,Hyervitaminosis D,25-hydroxy vitamin D,Hypercalcemia, Postmenopausal females, Biochemical parameters.