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Hypervitaminosis D and acute interstitial nephritis: Tale of injections

1 Department of Nephrology, Sir Ganga Ram Hospital, New Delhi, India
2 Department of Institute of Medical Genetics, Sir Ganga Ram Hospital, New Delhi, India
3 Department of Nephrology, PGIMER, Chandigarh, India
4 Department of Pathology, Sir Ganga Ram Hospital, New Delhi, India

Correspondence Address:
Vaibhav Tiwari,
Old Rajinder Nagar, New Delhi - 110 060
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijn.IJN_389_20

A 33-year-old man came with nausea, vomiting and abdominal pain due to hypercalcaemia and renal dysfunction following two doses of intramuscular vitamin D injections. Levels of vitamin D were repeatedly above 300 ng/ml over a period of 10 months. Whole-body PET CT scan revealed a thin-walled collection in the right gluteal region. The patient refused a surgical intervention for the same. After 7 months of follow-up, the abscess ruptured spontaneously and was then surgically debrided. At this point, a history of pentazocine addiction was uncovered. One month later, vitamin D levels began to fall along with improvement in serum calcium and creatinine. This case unravels a diagnostic odyssey which ended with a simple surgical debridement. We aim to highlight that vitamin D supplementation in 'megadoses' in the presence of active infection can have an exaggerated response and may take months to resolve.

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Indian Journal of Nephrology
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