[Metabolic encephalopathy secondary to vitamin D intoxication]

Nutr Hosp. 2014 Oct 25;31(3):1449-51. doi: 10.3305/nh.2015.31.3.8189.
[Article in Spanish]

Abstract

The association between vitamin D deficiency and increased risk of, among others, cardiovascular and autoimmune diseases has lead in the last years to an enhanced interest in the usage of supplements to achieve the normalization of plasmatic values at 25(OH) D. Apparently this search for normalization is resulting in an higher incidence on vitamin D intoxication. We present the case of an 81 years old woman with metabolic encephalopathy and renal failure secondary to iatrogenic vitamin D intoxication. Calcium and vitamin D oral supplements were prescribed after an osteoporotic vertebral fracture. The patient improved clinically as well as analytically after receiving treatment with diuretics and hydration. We emphasize the importance of discarding hypercalcemia as a cause of metabolic encephalopathy; moreover we highly recommend keeping vitamin D intoxication in mind as an uncommon although always possible etiology of reversible hypercalcemia and renal failure.

La asociación entre la deficiencia de vitamina D y un mayor riesgo de diversas enfermedades, entre ellas cardiovasculares y autoinmunes, ha aumentado en los últimos años el uso de suplementos para la normalización de los valores plasmáticos de esta vitamina. Desde entonces se ha descrito un mayor número de casos de intoxicación iatrogénica por vitamina D. Presentamos una enferma de 81 años con encefalopatía metabólica e insuficiencia renal secundarias a una intoxicación por vitamina D. Los suplementos orales con calcio y vitamina D se le prescribieron después de sufrir una fractura vertebral osteoporótica. La enferma mejoró clínica y analíticamente tras hidratación y diuréticos. Es importante destacar la hipercalcemia como causa de encefalopatía metabólica y considerar la intoxicación por vitamina D como etiología poco frecuente pero posible de hipercalcemia e insuficiencia renal reversibles.

Publication types

  • Case Reports

MeSH terms

  • Accidental Falls
  • Administration, Oral
  • Aged, 80 and over
  • Brain Diseases, Metabolic / chemically induced*
  • Brain Diseases, Metabolic / diagnosis
  • Brain Diseases, Metabolic / therapy
  • Calcifediol / adverse effects*
  • Calcium / adverse effects
  • Calcium / therapeutic use
  • Cognition Disorders / etiology*
  • Cognition Disorders / therapy
  • Craniocerebral Trauma / complications
  • Dehydration / complications
  • Dementia, Multi-Infarct / diagnosis
  • Dietary Supplements / adverse effects*
  • Female
  • Fluid Therapy
  • Fractures, Spontaneous / etiology
  • Furosemide / therapeutic use
  • Humans
  • Hypercalcemia / chemically induced*
  • Hypercalcemia / complications
  • Hyperphosphatemia / chemically induced
  • Iatrogenic Disease
  • Osteoporosis, Postmenopausal / complications
  • Osteoporosis, Postmenopausal / drug therapy
  • Remission Induction
  • Vitamin D / analogs & derivatives
  • Vitamin D / blood

Substances

  • Vitamin D
  • Furosemide
  • 25-hydroxyvitamin D
  • Calcifediol
  • Calcium