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- W3136109776 abstract "Sir, We read with great interest the report by Sarma et al. regarding the vitamin D toxicity and hypercalcaemia.[1] Considering that other causes of parathormone (PTH) independent hypercalcaemia are themselves not very common, vitamin D toxicity should figure high in the list of suspected causes. However, we would like to point out that although the recommended daily allowance of vitamin D is 800 IU/day, the tolerable upper intake level of vitamin D is 4000 IU/day as endorsed by the Institute of Medicine and the Endocrine Practice Committee guidelines.[2] Hence, we suspect that additional intake of vitamin D must be present in the case mentioned by Sarma et al. who reported that the patient was on 2400 IU of vitamin D daily.[1] Since oral vitamin D preparations available in the country exist in strengths of 1000/2000 IU (intended for daily use) as well as 60000 IU (intended for weekly/monthly use in Vitamin D deficiency), such errors in dosing are not uncommon. Further, several physicians still use the 6 lakh units intramuscular injections of vitamin D, ostensibly to eliminate compliance issues. Further, we would like to mention that vitamin D toxicity responds better to high doses of glucocorticoids (100 mg/day hydrocortisone or equivalent) rather than low dose glucocorticoids.[3] While severe hypercalcaemia may require bisphosphonate therapy, considering the gastrointestinal side effects and slower onset of action of oral bisphosphonates, intravenous bisphosphonates are preferred agents for use in hypercalcaemia.[4] Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest." @default.
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- W3136109776 date "2021-01-01" @default.
- W3136109776 modified "2023-09-23" @default.
- W3136109776 title "Vitamin D toxicity and hypercalcaemia" @default.
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- W3136109776 doi "https://doi.org/10.4103/ija.ija_1355_20" @default.
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