Hypervitaminosis D and acute interstitial nephritis: Tale of injections

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Abstract

A 33-year-old man came with nausea, vomiting and abdominal pain due to hypercalcaemia and renal dysfunction following two doses of intramuscular vitamin D injections. Levels of vitamin D were repeatedly above 300 ng/ml over a period of 10 months. Whole-body PET CT scan revealed a thin-walled collection in the right gluteal region. The patient refused a surgical intervention for the same. After 7 months of follow-up, the abscess ruptured spontaneously and was then surgically debrided. At this point, a history of pentazocine addiction was uncovered. One month later, vitamin D levels began to fall along with improvement in serum calcium and creatinine. This case unravels a diagnostic odyssey which ended with a simple surgical debridement. We aim to highlight that vitamin D supplementation in 'megadoses' in the presence of active infection can have an exaggerated response and may take months to resolve.

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Tiwari, V., Arora, V., Rajput, J., Gupta, A., Divyaveer, S., Bijarnia-Mahay, S., … Rana, D. S. (2022). Hypervitaminosis D and acute interstitial nephritis: Tale of injections. Indian Journal of Nephrology, 32(1), 71–75. https://doi.org/10.4103/ijn.IJN_389_20

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