Avtor/Urednik		Jensterle, M; Pfeifer, M; Sever, M; Kocjan, T
Naslov		Dihydrotachysterol intoxication treated with pamidronate: a case report
Tip		članek
Vir		Cases J
Vol. in št.		Letnik 3, št. 78
Leto izdaje		2010
Obseg		str. 1-6
Jezik		eng
Abstrakt		Introduction: Hypoparathyroidism is a chronic condition which requires a lifelong substitution with vitamin D analogues and careful monitoring. This is especially true for older patients and older compounds as dihydrotachysterol (DHT) with longer half-life that might lead to long-lasting hypercalcemic episodes. CASE Presentation: A 74-year old male patient with postsurgical hypoparathyroidism who has been successfully supplemented with DHT (1.7 ml qd) for over 50 years presented with neuropsychiatric disturbances, constipation, renal insufficiency and polyuria. Laboratory investigation demonstrated serum calcium 3.7 mmol/L, serum creatinine 180 micromol/L, urine calcium excretion 1.1 mmol/mmol of the creatinine, normal 25 OH vitamin D3 and low PTH and 1,25 di OH vitamin D3. Careful history revealed that he has been erroneously taking 2.5 ml of DHT per day for at least 6 to 8 weeks what caused vitamin D intoxication and symptomatic hypercalcemia. He was treated with intravenous saline infusion, careful administration of loop diuretic when needed, methylprednisolone and 60 mg of intravenous sodium pamidronate. On the fourth day after admission serum calcium dropped rapidly into the normal range. The treatment for hypoparathyroidism had to be reinstituted 10 days after DHT had been discontinued when the patient was switched to shorter acting calcitriol. Conclusions: Here we reported that the immediate use of pamidronate in addition to classic treatment of DHT intoxication with intravenous saline, diuretics and glucocorticoids is an effective treatment choice that leads to rapid resolution of hypercalcemia.
Deskriptorji		HYPOPARATHYROIDISM DIHYDROTACHYSTEROL OVERDOSE HYPERCALCEMIA DIPHOSPHONATES METHYLPREDNISOLONE AGED