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hypervitaminosis D
Etiology:
- mycosis
- tuberculosis
- sarcoidosis
- lymphoma
- excessive dietary intake
Pathology:
1) unregulated conversion of 25-OH vitamin D to 1,25-dihydroxyvitamin D within granulomatous tissue
2) hypercalcemia
a) nephrocalcinosis
b) may take over 2 months to resolve
3) hyperphosphatemia
4) corneal opacification
Clinical manifestations:
- dyspnea on exertion suggests pulmonary sarcoidosis
Laboratory:
- very high 25-hydroxy vitamin D in serum
- high serum phosphate
- high serum calcium
- low serum PTH
Radiology:
- chest X-ray with prominent upper lobe infiltrates & hilar enlargement suggests pulmonary sarcoidosis
Management:
- symptomatic hypercalcemia due to vitamin D should be treated with prednisone
Related
vitamin D
General
hypervitaminosis
References
- Medical Knowledge Self Assessment Program (MKSAP) 20
American College of Physicians, Philadelphia 2025