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Protracted Vitamin D Intoxication

Kaup R. Shetty, MD; Kamel Ajlouni, MD; Paul S. Rosenfeld, MD; Thad C. Hagen, MD
Arch Intern Med. 1975;135(7):986-988. doi:10.1001/archinte.1975.00330070108018.
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The characteristic features of vitamin D toxicity from excessive doses of irradiated ergosterol were first described in animals by Kreitmair and Moll in 1928.1 In the same year, Hess and Lewis reported clinical hypervitaminosis D in man.2 One year later, Putschar reported the first death from vitamin D overdosage.3 We are reporting a case of vitamin D intoxication extending through a 22-month period.

PATIENT SUMMARY  A 56-year-old woman underwent subtotal thyroidectomy for Graves disease at another institution in 1963. After the operation, hypoparathyroidism developed and therapy was begun with vitamin D2 (ergocalciferol), 100,000 units daily. Subsequently, when she was found to be hypothyroid, she received 200 mg of desiccated thyroid daily. Four months later, after hypercalcemia (14 mg/100 ml) had been noted, vitamin D therapy was discontinued. Three months later, hypocalcemia recurred and, following a demonstration of increased phosphate excretion in response to exogenous parathyroid hormone


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