An Outbreak of Vitamin D Toxicity in a Family: Report of 3 Cases From Unregulated Fortification
Recommended Citation
Jha V, Rouniyar R, Rao SD, Dua A, and Bhadada SK. An Outbreak of Vitamin D Toxicity in a Family: Report of 3 Cases From Unregulated Fortification. JCEM Case Rep 2025;3(12):luaf230.
Document Type
Article
Publication Date
12-1-2025
Publication Title
JCEM Case Rep
Keywords
community outbreak; cooking oil contamination; food fortification; hypercalcemia; vitamin D toxicity
Abstract
Vitamin D toxicity is a rare but potentially life-threatening cause of PTH-independent hypercalcemia. While most cases result from inappropriate supplement use, food-related exposures are increasingly recognized. We report a cluster of 3 adults from the same household who presented within 3 days with severe hypercalcemia and acute kidney injury. All had markedly elevated 25-hydroxyvitamin D, suppressed intact PTH, and a shared history of consuming locally sourced, unpackaged cooking oil. Liquid chromatography-tandem mass spectrometry analysis of the retained oil confirmed toxic vitamin D(3) contamination at 1286 μg/mL (SI: ∼3.34 × 10(6) nmol/L). Treatment included IV fluids, calcitonin, and denosumab; 1 required dialysis. All recovered fully. This case series highlights the need to consider dietary sources in familial hypercalcemia and underscores the importance of regulating food fortification and edible product safety.
PubMed ID
41179273
Volume
3
Issue
12
First Page
230
Last Page
230
