{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T20:29:05Z","timestamp":1786739345745,"version":"build-2736575974"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Vitamin D toxicity (VDT), a \u201cnot uncommon\u201d cause of hypercalcemia, can be life-threatening and cause substantial morbidity, if not treated promptly.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims:<\/jats:title>\n                    <jats:p>To describe presentation, management, and outcome in 32 patients with VDT diagnosed over 3 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>Patients presenting with VDT at a tertiary care centre in Srinagar Kashmir India were included. Evaluation included detailed history and biochemical tests including serum calcium, phosphate, creatinine, intact parathyroid hormone (iPTH), 25-hydroxy Vitamin D (25-OHD), and 24-hour urinary calcium.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The clinical manifestations of the 32 patients (median age 65; range 3\u201377 years) included gastrointestinal symptoms (constipation and vomiting), polyuria\/polydipsia, altered sensorium, pancreatitis, acute kidney injury, and nephrocalcinosis. The median total serum calcium level was 13.95 (range 11.10-17.20) mg\/dl and median 25-OHD level was 306 (range 105\u20132800) ng\/ml. All patients had suppressed or low normal iPTH and hypercalciuria and 78% had azotemia. All patients had received multiple intramuscular injections of vitamin D\n                      <jats:sub>3<\/jats:sub>\n                      . The median cumulative dose was 4,200,000 (range, 1,800,000-30,000,000) IU. The median time to resolution of hypercalcemia was 7 months (range 4\u201318 months).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>We conclude that VDT is an increasingly common cause of symptomatic hypercalcemia. VDT needs prolonged follow up as it takes months to abate its toxicity. Enhancing awareness among general practitioners regarding the toxicity resulting from high doses of vitamin D is the key to prevent VDT. We suggest that VDT be considered in patients, especially the elderly, presenting with polyuria, polydispsia, vomiting, azotemia, or encephalopathy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijem.ijem_116_19","type":"journal-article","created":{"date-parts":[[2019,7,29]],"date-time":"2019-07-29T06:58:27Z","timestamp":1564383507000},"page":"363-366","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":24,"title":["Vitamin D Toxicity: A Prospective Study from a Tertiary Care Centre in Kashmir Valley"],"prefix":"10.4103","volume":"23","author":[{"given":"Raiz A.","family":"Misgar","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, Jammu and Kashmir, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danendra","family":"Sahu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, Jammu and Kashmir, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moomin H.","family":"Bhat","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, Jammu and Kashmir, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arshad I.","family":"Wani","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, Jammu and Kashmir, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mir I.","family":"Bashir","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, Jammu and Kashmir, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20260327","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.pbiomolbio.2006.02.016","article-title":"Vitamin D physiology","volume":"92","author":"Lips","year":"2006","journal-title":"Prog Biophys Mol Biol"},{"key":"R2-20260327","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1017\/S0007114513001840","article-title":"A systematic review of vitamin D status in populations worldwide","volume":"111","author":"Hilger","year":"2014","journal-title":"Br J Nutr"},{"key":"R3-20260327","doi-asserted-by":"crossref","first-page":"1911","DOI":"10.1210\/jc.2011-0385","article-title":"Evaluation, treatment, and prevention of vitamin D deficiency: An endocrine society clinical practice guideline","volume":"96","author":"Holick","year":"2011","journal-title":"J Clin Endocrinol Metab"},{"key":"R4-20260327","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1159\/000443136","article-title":"Global consensus recommendations on prevention and management of nutritional rickets","volume":"85","author":"Munns","year":"2016","journal-title":"Horm Res Paediatr"},{"key":"R5-20260327","first-page":"756","article-title":"Vitamin D toxicity","volume":"29","author":"Marcinowska-Suchowierska","year":"2016","journal-title":"Post N Med"},{"key":"R7-20260327","doi-asserted-by":"crossref","first-page":"842","DOI":"10.1093\/ajcn\/69.5.842","article-title":"Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety","volume":"69","author":"Vieth","year":"1999","journal-title":"Am J Clin Nutr"},{"key":"R8-20260327","doi-asserted-by":"crossref","first-page":"54","DOI":"10.4103\/2230-8210.77588","article-title":"Primary hyperparathyroidism presenting as recurrent acute pancreatitis: A case report and review of literature","volume":"15","author":"Misgar","year":"2011","journal-title":"Indian J Endocrinol Metab"},{"key":"R9-20260327","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1042\/cs0430413","article-title":"The distribution and storage of vitamin D and its metabolites in human tissues","volume":"43","author":"Mawer","year":"1972","journal-title":"Clin Sci"},{"key":"R10-20260327","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1093\/tropej\/fmp020","article-title":"Hypercalcemia due to hypervitaminosis D: Report of seven patients","volume":"55","author":"Joshi","year":"2009","journal-title":"J Trop Pediatr"},{"key":"R11-20260327","doi-asserted-by":"crossref","first-page":"201","DOI":"10.5001\/omj.2011.49","article-title":"Vitamin D toxicity in adults: A case series from an area with endemic hypovitaminosis D","volume":"26","author":"Koul","year":"2011","journal-title":"Oman Med J"},{"key":"R12-20260327","first-page":"118","article-title":"\u201cExcess gooD can be Dangerous\u201d. A case series of iatrogenic symptomatic hypercalcemia due to hypervitaminosis D","volume":"9","author":"Pandita","year":"2012","journal-title":"Clin Cases Miner Bone Metab"},{"key":"R13-20260327","doi-asserted-by":"crossref","first-page":"295","DOI":"10.4103\/2230-8210.93773","article-title":"Vitamin D toxicity","volume":"16","author":"Maji","year":"2012","journal-title":"Indian J Endocrinol Metab"},{"key":"R14-20260327","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1111\/cen.12836","article-title":"Vitamin D toxicity resulting from overzealous correction of vitamin D deficiency","volume":"83","author":"Kaur","year":"2015","journal-title":"Clin Endocrinol (Oxf)"},{"key":"R15-20260327","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1016\/0169-6009(90)90023-9","article-title":"The mechanisms of vitamin D toxicity","volume":"11","author":"Vieth","year":"1990","journal-title":"Bone Miner"}],"container-title":["Indian Journal of Endocrinology and Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/02223308-201923030-00016","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T19:28:13Z","timestamp":1786735693000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/02223308-201923030-00016"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,5]]},"references-count":14,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2019]]}},"URL":"https:\/\/doi.org\/10.4103\/ijem.ijem_116_19","relation":{},"ISSN":["2230-8210","2230-9500"],"issn-type":[{"value":"2230-8210","type":"print"},{"value":"2230-9500","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,5]]}}}