Which of the following is a common sign seen in a patient with vitamin D toxicity?

• A. Hypocalcemia
• B. Metabolic bone disease
• C. Soft tissue calcification
• D. Hypophosphatemia

Answer: (C)

Excess vitamin D drives increased intestinal absorption of calcium (and phosphate), raising their levels in the blood and promoting deposition of calcium-phosphate in soft tissues. This metastatic calcification is the hallmark sign of vitamin D toxicity, making soft tissue calcification the most likely and characteristic finding. In contrast, vitamin D excess typically causes hypercalcemia rather than hypocalcemia, and the bone problems described as metabolic bone disease are more aligned with insufficient vitamin D or other bone remodeling disorders. Phosphate tends to be elevated with vitamin D toxicity, not decreased, so hypophosphatemia wouldn’t fit.