Not 100% convinced that this would be your sole
diagnosis. Enthusiastic lifeguards can get
plasma 25D in this sort of range, and they don't
generally get severe hypercalcaemia. There is an
argument proposed by some (eg Veith) that almost
everyone with 25D below the upper limit of the summer
reference range you give (85nmol/L) is Vitamin D
deficient.
It is pretty hard to make oneself severely vitamin D
toxic and markedly hypercalcaemic using easily
available sources of Vitamin D.
Case reports of vitamin D intoxication with severe
hypercalcaemia generally have very high doses (eg
50,000 units of Vitamin D per day for long periods of time)
See for example N Eng J Med 345. 66 (2001), or the
Lancet case collection May 31st 1980 (mostly iatrogenic).
Possible, but.... what vitamin D did he take and where
did he get it? Was it in the form of a calcium/D
supplement? - in which case he probably has calcium
rather than Vitamin D poisoning.
Aubrey
DIB> I received the results of Vit D. The
DIB> patient was hospitalized the 25th
DIB> of november. The results of the specimen
DIB> taken the 1st of december
DIB> were:
DIB> 1,25 Vit D 118.2 pM (RV 41-145)
DIB> 25 Vit D 212.8 nM (RV summer 35 - 85; winter 25 - 60)
DIB> So most probably it was a case of vit D. intoxication
DIB> Thanks for your comments and suggestions in this case.
DIB> Ihssan
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