Hypervitaminosis D and Acute Interstitial Nephritis: Tale of Injections

Indian J Nephrol. 2022 Jan-Feb;32(1):71-75. doi: 10.4103/ijn.IJN_389_20. Epub 2021 Dec 30.

Abstract

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.

Keywords: AIN; AKI; gluteal abscess; hypervitaminosis D.

Publication types

  • Case Reports