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Apart from maintaining healthy bones, vitamin D is also required for cell differentiation, cell growth inhibition, and immune modulation. Vitamin D deficiency is common in the Indian subcontinent. Vitamin D presenting toxicity, leading to hypercalcemia, acute kidney injury, and altered sensorium is very rare. Here we present a case of a 65-year-old man who presented to emergency with persistent vomiting, altered sensorium, and acute kidney injury. The cause of which was an unchecked intake of vitamin D for non-specific musculoskeletal pain. When treated with intravenous fluid, diuretics, calcitonin, and steroids, the patient improved clinically. Therefore, for any patient presenting with persistent vomiting, altered sensorium, and hypercalcemia, with normal to low parathyroid hormone levels, a diagnosis of an overdose of vitamin D should be considered. Early treatment of this condition not only improves the symptoms but also prevents further kidney damage.

Objective: The aim was to evaluate the efficacy and safety profile of dapsone as a cheap second-line treatment for chronic immune thrombocytopenia (ITP) in developing countries. Materials and Methods: A prospective study on 100 chronic ITP patients. These patients were put on dapsone after ruling out glucose 6 phosphate dehydrogenase deficiency and secondary causes of ITP. Results: The basic work up for secondary causes of ITP was negative. All these patients had been treated with steroids in the past. Anti-D had been given acutely in 20 patients, and intravenous immunoglobulin G had been given in 10 patients. Vincristine had been given to 20 of these patients. Dapsone was started in these patients, and 44% patients showed a response to treatment. The mean time to onset of response was 21 days. Out of these 44 patients, 21 (47.7%) went into remission and had platelet count >100,000/μl at 2 years post tapering of the treatment. Remaining 23 patients were kept on low dose dapsone and maintained their platelet counts. Adverse drug reactions included mild skin eruptions in 5% of patients, pruritus in 10% of patients, dose-related hemolysis in 1% of patients, methemoglobinemia in 1% of patients and Stevens Johnson syndrome in 1% of patients. 56 patients were nonresponders to the available, affordable conventional medical treatment and were referred to the surgical department for splenectomy, with a cure rate of 86% postsurgery. Conclusions: Dapsone is a safe, cheap and effective treatment option for patients with chronic ITP, who cannot afford the usual costlier second-line drugs.