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Iatrogenic Hypercalcemia Due to Vitamin D 3 Ointment (1,24(OH) 2 D 3 ) Combined with Thiazide Diuretics in a Case of Psoriasis
Author(s) -
Kawaguchi Masakazu,
Mitsuhashi Yoshihiko,
Kondo Shigeo
Publication year - 2003
Publication title -
the journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.9
H-Index - 65
eISSN - 1346-8138
pISSN - 0385-2407
DOI - 10.1111/j.1346-8138.2003.tb00481.x
Subject(s) - thiazide , psoriasis , medicine , urinary calcium , hypercalciuria , calcium , vitamin d and neurology , vitamin , excretion , urinary system , endocrinology , urology , dermatology , gastroenterology , diuretic
Tacalcitol is a synthetic vitamin D 3 analogue developed for topical treatment of inflammatory skin diseases such as psoriasis. Hypercalcemia has not been previously reported during treatment with topical tacalcitol. We experienced a male patient with psoriasis and hypertension whose conditions were treated with tacalcitol ointment and thiazide, respectively, resulting in hypercalciuria and hypercalcemia. After initiation of topical vitamin D 3 ointment (20 μg/g of tacalcitol) 10 g/day for the skin lesions, both the serum level of calcium and urinary excretion of calcium increased gradually. On day 28 of the treatment, his serum calcium levels had reached 3.55 mmol/l, and his urinary calcium excretion had also increased from 0.008 g/day to 0.475 g/day. The tacalcitol treatment was terminated, seven days later, the serum calcium level had returned to the reference range without any specific treatment. The present case is the first report of hypercalcemia induced by vitamin D 3 ointment and thiazide simultaneously.