INTOXICATION RESULTING FROM THE ADMINISTRATION OF MASSIVE DOSES OF VITAMIN D, With Report of Five Cases

Abstract

Massive doses of vit. D, as used in the treatment of arthritis, may produce symptoms of intoxication, the commonest being anorexia, nausea, vomiting, headache and others; they are based on degenerative changes produced in various parenchymatous organs of which the kidney shows the greatest damage; cellular degeneration is followed by deposition of Ca. The clinical evidence of this damage may be the presence of albumin and casts, an increase in blood NPN and reduction of the kidney function as demonstrated by reduced phenolsulphonphthalein output or urea clearance. The presence of arteriosclerosis or of any renal pathology is a distinct contraindication to its use. One of the reported cases suggests that mental deterioration may also be a contraindication. The aged patient seems more susceptible than the younger individual. Signs of renal damage usually but not always disappear after the drug is withdrawn but evidence of permanent damage may remain. The use of this drug in massive doses should be carefully and consistently supervised, the dosage should not exceed 150,000 units/day, and should be stopped at the first sign of intoxication.