vitamin d intoxication with hypercalcemia due to overuse of supplement

we describe a patient with hypercalcemia associated with the injection of high doses vitamin d as supplement for a period of six months. a 76-year-old woman had been taking an intramuscular injection of vitamin d 300,000 iu every ten days for six months. she was hospitalized with symptoms of hypercalcemia: chronic constipation, unstable gait, a chronic generalized musculoskeletal pain and increased fatigue. on admission her 25 (oh) vitamin d and calcium levels were 559 nmol/l and 13.85 mg/dl respectively, and parathyroid hormone (pth) level was 7.1 pg/ml. immediately she received diuresis therapy with saline and furosemide in conjunction with calcitonin and pamidronate. at discharge her serum calcium level was 11.5 mg/dl. to lower endogenous overproduction of calcitriol, prednisolone 20 mg/day for 10 days was administered at discharge time.