ECE2020 Audio ePoster Presentations Bone and Calcium (121 abstracts)
Clinical characteristics of subjects with very high serum 25 OH vitamin D levels in turkey: DeVIT-TOX survey
Zafer Pekkolay 1 , Dilek Gogas Yavuz 2 , Emre Sedar Saygili 3 , Ömercan Topaloğlu 4 , Çağatay Emir Önder 5 , Hikmet Soylu 6 , Isilay Taskaldiran 5 , Ayșe Esen Pazır 7 , Kader Ugur 8 , Seher Tanrikulu 9 , Sevde Nur Firat 5 , Burcu Meryem Atak 10 , Adnan Batman 11 , Tülay Omma 5 , Eylem Cagiltay 12 , Nilufer Ozdemir Kutbay 13 , Seher Çetinkaya Altuntaș 14 , Narin Nasiroglu Imga 15 , Ersen Karakilic 16 , Zeliha Hekimsoy 17 , Faruk Kılınç 18 , Adnan Yay 19 , Mustafa Eroğlu 20 & Alpaslan Kemal Tuzcu 1
1Dicle University Faculty of Medicine, Adult Endocrinology, Diyarbakır, Turkey; 2Marmara University Faculty of Medicine, Adult Endocrinology, İstanbul, Turkey; 3Çanakkale State Hospital, Adult Endocrinology, Çanakkale, Turkey; 4Kocaeli Training and Research Hospital, Endocrinology Clinics, Kocaeli, Turkey; 5Ankara Training and Research Hospital, Adult Endocrinology, Ankara, Turkey; 6Gazi Yașargil Training and Research Hospital, Endocrinology Clinics, Diyarbakır, Turkey; 7Sadi Konuk Training and Research Hospital, Adult Endocrinology, İstanbul, Turkey; 8Fırat University Faculty of Medicine, Adult Endocrinology, Elazığ, Turkey; 9Haydarpașa Numune Training and Research Hospital, Adult Endocrinology, İstanbul, Turkey; 10Akdeniz University Faculty of Medicine, Adult Endocrinology, Antalya, Turkey; 11Şișli Hamidiye Etfal Training and Research Hospital, Adult Endocrinology, İstanbul, Turkey; 12Sultan Abdülhamid Han Training and Research Hospital, Adult Endocrinology, İstanbul, Turkey; 13Celal Bayar University Faculty of Medicine, Adult Endocrinology, Manisa, Turkey; 14Recep Tayyip Erdogan University, Adult Endocrinology, Rize, Turkey; 15Ankara Numune Training and Research Hospital, Adult Endocrinology, Ankara, Turkey; 16Çanakkale Onsekiz Mart University Faculty of Medicine, Adult Endocrinology, Çanakkale, Turkey; 17Celal Bayar University Faculty of Medicine, Adult Endocrinology, Manisa, Turkey; 18Fırat University Faculty of Medicine, Adult Endocrinology, Elazığ, Turkey; 19Sultan Abdulhamid Han Training and Research Hospital, Adult Endocrinology, İstanbul, Turkey; 20Balıkesir University Faculty of Medicine, Adult Endocrinology, Balıkesir, Turkey
Background: Treatment of vitamin D deficiency orinappropriate vitamin D supplementation may cause side effects associated with hypercalcemia. We observed a tendency to use very high single dose cholecalciferol for treatment of vitamin D deficiency.
Aim: The primary aim of this study was to examine the clinical characteristics of patientswith very high serum 25OHD levels of vitamin D toxicity in Turkey.
Materials and methods: An invitation was sent to all tertiary endocrinology clinics of Turkey to complete a retrospective survey for the diagnosed high serum 25OHDlevels (>88 ng/dl ) and/or vitamin D toxicity, between January 2019 and December 2019. Twenty-threecenters responded from 19 cities. Subjects evaluated according to the presence of signs and or symptoms of hypercalcemia. The evaluation also is doneaccording to 25OHD levels >150 ng/dl (Group 1), 149–100 ng/dl (Group 2), 99-88 ng/dl (Group 3).
Results: Two hundred and fifty-three patients included in the final analysis (female/male: 215/38,: 51.5±15 yrs ). Serum 25OHD level:119.9 ± 33 (min-max 88-259) ng/dl, and serumcalcium level was 9.8 ± 0.7 (min-max 8.1–13.1) mg/dl.
Most ofthe patients were asymptomatic (n = 201, 75.4%)despite high vitamin D and calcium levels. Serum 25OHD levels was significantly higher in the symptomatic group(138.6 ± 64 ng/dl) compared to asymptomatic group (117.7 ± 31 ng/dl) (P < 0.05). Serum calcium levels were10.36 ± 1.0 mg/dl vs 9.7 ± 0.6 mg/dl (P < 0.01) for symptomaticand asymptomatic groups, respectively. The symptomatic group was older than others (P < 0.05). Serum intact PTH level was similar between groups. There was no significant difference in terms of age,serum calcium and iPTH levels in group 1,2 and 3. Inappropriate prescribed high dose oral vitamin intake (600.000-1.500.000 IU) in short term (1–3 months) for treatment ofdeficiency/insufficiencyis to the most common reason (73%) associated with high serum 25OHD levels.75.9% of patients who developed toxicity(serum 25OHD >150 ng/dl) used the vial form (300.000 IU/1 vial = 1 ml) twice consequently.
Conclusions: High serum 25OHD levels were associated with very high dose vitamin D intake. To avoid vitamin D toxicity and related complications need to avoidusing very high dose of cholecalciferol. Clinical guidelines recommendations for the treatment of vitamin D deficiency are effective and safe.
Keywords: vitamin D, toxicity, hypercalcemia
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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