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VITAMIN D INTOXICATION: REPORT OF TWO CASES TREATED WITH CORTISONE

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1958

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Article1 April 1958VITAMIN D INTOXICATION: REPORT OF TWO CASES TREATED WITH CORTISONEJOHN V. VERNER JR., M.D., FRANK L. ENGEL, M.D., HARRY T. MCPHERSON, M.D.JOHN V. VERNER JR., M.D.Search for more papers by this author, FRANK L. ENGEL, M.D.Search for more papers by this author, HARRY T. MCPHERSON, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-48-4-765 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptExcessive vitamin D ingestion has been known since 1928 to produce toxic effects in humans.1 Knowledge of these harmful effects has in recent years led physicians away from the use of large doses of this vitamin. The syndrome of vitamin D intoxication still occurs, however, and may present difficult diagnostic and therapeutic problems. Donegan et al.2 reported two such cases from this institution in 1949. Two additional cases are reported here because of the gratifying response to cortisone therapy and because they manifest interesting features not sufficiently stressed in the existing literature.CASE REPORTSCase 1. This 71 year old...Bibliography1. HessLewis AFJM: Clinical experience with irradiated ergosterol, J. A. M. A. 91: 783-788, 1928. CrossrefGoogle Scholar2. DoneganMesserOrgain CKALES: Vitamin D intoxication due to estron: report of two cases, Ann. Int. Med. 30: 429-435, 1949. LinkGoogle Scholar3. AnningDawsonDolbyIngram STJDEJT: Toxic effects of calciferol, Quart. J. Med. 17: 203-228, 1948. MedlineGoogle Scholar4. ChaplinClarkRopes HLDMW: Vitamin D intoxication, Am. J. M. Sc. 221: 369-378, 1951. CrossrefMedlineGoogle Scholar5. CoveyWhitlock GWHH: Intoxication resulting from the administration of massive doses of vitamin D, with report of five cases, Ann. Int. Med. 25: 508-515, 1946. LinkGoogle Scholar6. HowardMeyer JERJ: Intoxication with vitamin D, J. Clin. Endocrinol. 8: 895-910, 1948. CrossrefMedlineGoogle Scholar7. Albright F: The parathyroid glands and metabolic bone disease, 1948, The Williams and Wilkins Co., Baltimore. Google Scholar8. Lightwood R: Idiopathic hypercalcemia with failure to thrive: nephrocalcinosis, Proc. Roy. Soc. Med. 45: 401-402, 1952. Google Scholar9. KabakowMinesKing BMFFH: Hypercalcemia in Hodgkin's disease, New England J. Med. 256: 59-62, 1956. CrossrefGoogle Scholar10. MawdsleyHolman CRL: Hypercalcemia in acute leukemia, Lancet 1: 78, 1957. CrossrefGoogle Scholar11. BurnettCommonsAlbrightHoward CHRRFJE: Hypercalcemia without hypercalciuria or hypophosphatemia, calcinosis, and renal insufficiency; syndrome following prolonged intake of milk and alkali, New England J. Med. 240: 787-794, 1949. CrossrefMedlineGoogle Scholar12. PlimptonGellhorn CHA: Hypercalcemia in malignant disease without evidence of bone destruction, Am. J. Med. 21: 750-759, 1956. CrossrefMedlineGoogle Scholar13. HennemanDempseyCarrollAlbright PHEFELF: The cause of hypercalcemia in sarcoid and its treatment with cortisone and sodium phytate, J. Clin. Investigation 35: 1229-1242, 1956. CrossrefMedlineGoogle Scholar14. HarrisonHarrison HEHC: The renal excretion of inorganic phosphate in relation to the action of vitamin D and parathyroid hormone, J. Clin. Investigation 20: 47-55, 1941. CrossrefMedlineGoogle Scholar15. Kodicek E: Metabolic studies on vitamin D, in Ciba Foundation Symposium, Bone structure and metabolism, 1956, Little, Brown and Company, Boston, pp. 161-174. CrossrefGoogle Scholar16. FreybergGrant RHRL: Calcium and phosphorus metabolism in a verified case of pituitary basophilism, Arch. Int. Med. 58: 213-228, 1936. CrossrefGoogle Scholar17. Soffer LJ: Symposium on endocrine and metabolic disorder; ACTH and cortisone; physiologic and clinical considerations, M. Clin. North America 36: 791-809, 1952. CrossrefMedlineGoogle Scholar18. MoehligSteinbach RCAL: Cortisone interference with calcium therapy in hypoparathyroidism, J. A. M. A. 154: 42-44, 1954. CrossrefMedlineGoogle Scholar19. ColcherDrachmanAdlersberg HSRD: Management of intractable sprue with cortisone and adrenocorticotropin (ACTH), Ann. Int. Med. 38: 554-568, 1953. LinkGoogle Scholar20. HarrellFisher GTS: Blood chemical changes in Boeck's sarcoid with particular reference to protein, calcium and phosphatase values, J. Clin. Investigation 18: 687-693, 1939. CrossrefMedlineGoogle Scholar21. DentFlynnNabarro CEFVJD: Hypercalcemia and impairment of renal function in generalized sarcoidosis, Brit. M. J. 2: 808-810, 1953. CrossrefMedlineGoogle Scholar22. AndersonHarperDentPhilpot JCCEGR: Effect of cortisone on calcium metabolism in sarcoidosis with hypercalcemia, Lancet 2: 720-724, 1954. CrossrefGoogle Scholar23. ConnorHopkinsThomasCareyHoward TBTRWCRAJE: The use of cortisone and ACTH in hypercalcemic states, Abstracts of papers presented at the thirty-eighth annual meeting of the Endocrine Society, J. Clin. Endocrinol. and Metabolism, Abstract 75, 16: 945, 1956. Google Scholar24. Dent CE: Cortisone test for hyperparathyroidism, Letter to the editor, Brit. M. J. 1: 230, 1956. CrossrefGoogle Scholar25. Adams FD: Reversible uremia with hypercalcemia due to vitamin D intoxication, New England J. Med. 244: 590-592, 1951. CrossrefMedlineGoogle Scholar26. KaufmanBeckWiseman PRDRD: Vitamin D therapy in arthritis: treatment followed by massive metastatic calcification, renal damage, and death, J. A. M. A. 134: 688-690, 1947. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Durham, North Carolina*Received for publication July 2, 1957.From the Department of Medicine and Division of Endocrinology, Duke University, Durham, North Carolina.Requests for reprints should be addressed to Frank L. Engel, M.D., Division of Endocrinology, Duke University School of Medicine, Durham, North Carolina. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byJohn V. Verner Jr. and Ashton B. MorrisonPrimary HyperparathyroidismMedical management of hypercalcaemia.Nutrients as Supplements, Drugs, and NostrumsThe role of the paracellular pathway in the net transport of calcium across the colonic muscosaThe effect of prednisolone on kidney calcification in vitamin D-treated ratsEffects of vitamin DRenal and systemic acid-base effects of the chronic administration of hypercalcemia-producing agents: Calcitriol, PTH, and intravenous calciumCalcium lysosomes in rachitic and vitamin D3 replete chick duodenal absorptive cellsManagement of severe hypercalcaemia.Physiology and pharmacological regulation of bone resorptionGlucocorticoids and æstrogens in the management of hypercalcaemiaTreatment of severe hypecalcaemia with calcitoninVitamin D Actions in the Kidney (Excluding Vitamin D Metabolism)Possible prevention and treatment of steroid-induced osteoporosis.The functional metabolism of vitamin D in rats treated with cortisolInteractions between Vitamin D and the KidneySodium Cellulose Phosphate in Vitamin D IntoxicationBONE MINERAL IN SARCOIDOSISCorticosteroid osteoporosisTreatment of Vitamin D IntoxicationEffects of Vitamin D and Steroid Hormones on the Active Transport of Calcium by the IntestineTHE PHYSIOLOGY AND PHARMACOLOGY OF THE GLUCOCORTICOIDSMeasurement and Meaning of Calcium AbsorptionStörungen der HarnkonzentrierungHormones and Calcium MetabolismHYPERCALCÆMIC NEPHROPATHYThe Response of Hypercalcemia in Sarcoidosis to ChloroquineBARBARA J. HUNT, M.B., CH.B., EDMUND REINHOLD YENDT, M.D., F.R.C.P.Electrolyte Complications of Drug TherapyRenal LithiasisThe diagnostic spectrum of hypercalcemiaDie Pathologie der Avitaminosen und HypervitaminosenRenal Tubular Acidosis and Renal Potassium Wasting Acquired as a Result of Hypercalcemic NephropathyBONE CHANGES ASSOCIATED WITH CORTISONE ADMINISTRATION IN THE RAT : CONVERSION OF ‘RICKETS’ TO ‘OSTEOPOROSIS’Sarcoidosis and Hyperparathyroidism with HypercalcemiaTHE SYMPTOMS OF HYPERCALCEMIA ASSOCIATED WITH SARCOIDOSIS MASQUERADING AS PEPTIC ULCER*ANTHONY J. RICHTSMEIER, M.D., F.A.C.P.IDIOPATHIC HYPOPARATHYROIDISM AND IDIOPATHIC ADRENAL CORTICAL INSUFFICIENCY OCCURRING WITH CYSTIC FIBROSIS OF THE PANCREAS*F. GILBERT MCMAHON, M.S., M.D., DAVID U. COOKSON, M.D., J. D. KABLER, M.D., STANLEY L. INHORN, M.D.TREATMENT OF ATYPICAL CASES OF SURGICAL HYPOPARATHYROIDISM 1 April 1958Volume 48, Issue 4Page: 765-773KeywordsCalciumEndocrinologyHypercalcemiaIngestionIntoxicationSaltsVitamin D ePublished: 1 December 2008 Issue Published: 1 April 1958 PDF downloadLoading ...

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