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Case report
Hypercalcaemia due to isolated elevation of 1,25-dihydroxyvitamin D in patients with Crohn’s disease
  1. Faisal Inayat1,
  2. Saad Saleem2,
  3. Adil Mohyudin3 and
  4. Zubair Khan4
  1. 1 Allama Iqbal Medical College, Lahore, Pakistan
  2. 2 Mercy Saint Vincent Medical Center, Toledo, Ohio, USA
  3. 3 Sheikh Zayed Medical College, Rahim Yar Khan, Pakistan
  4. 4 University of Toledo Medical Center, Toledo, Ohio, USA
  1. Correspondence to Dr Faisal Inayat, faisalinayat{at}hotmail.com

Abstract

Crohn’s disease is frequently associated with hypocalcaemia following poor calcium intake and decreased intestinal calcium absorption due to malabsorption-related vitamin D deficiency. Severe hypercalcaemia found in Crohn’s disease is an unusual clinical entity. We chronicle here the case of a patient who developed hypercalcaemia with elevated 1,25-dihydroxyvitamin D during Crohn’s disease exacerbation. Furthermore, we conducted a systematic literature search of MEDLINE, Cochrane, Embase, and Scopus databases regarding 1,25-dihydroxyvitamin D-associated hypercalcaemia in Crohn’s disease. A comprehensive review of the search results yielded a total of five case reports only. The data on patient demographics, clinical features, serum calcium levels, Crohn’s disease activity site, treatment strategy, hypercalcaemia resolution time and outcomes were collected and analysed. This paper illustrates that Crohn’s disease should be added to the list of granulomatous disorders responsible for 1,25-dihydroxyvitamin D-mediated hypercalcaemia. Physicians should maintain a high index of clinical suspicion for this potential complication for prompt management.

  • calcium and bone
  • vitamins and supplements
  • fluid electrolyte and acid-base disturbances
  • gastroenterology
  • Crohn’s disease
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Footnotes

  • Contributors FI: designed the study, reviewed the literature, drafted the manuscript, formulated the data tables and the flow diagram, and revised the manuscript for the important intellectual content. SS: reviewed the literature and contributed to the case presentation. AM: contributed to the discussion. ZK: reviewed the final version of the manuscript and gave approval for the version published.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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