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Vitamin A Intoxication

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Abstract

THE clinical entity of hypervitaminosis A was first described in 1944 by Josephs.1 In 1947 Toomey and Morissette2 published a study conducted with excellent controls which clearly established the etiology of the disease. Since that time, the diagnosis has been made with increasing frequency, with a total of 24 cases reported to date.3–16

Three clinical factors must be established before the diagnosis can be made: (1) a clear-cut history of excessive intake of vitamin A; (2) elevated levels of vitamin A in the blood; and (3) roentgenographic evidence of subperiosteal new bone formation. Other clinical manifestations which have been reported include hyperirritability, pruritus, rash, alopecia, tenderness over the long bones, cheilosis, and bleeding tendency.

In all cases reported there was rapid improvement in clinical appearance after the vitamin concentrate was eliminated from the diet. The bone changes disappeared also, but this was a much slower process and required a number of months.

The following case is presented as an example of this syndrome.

CASE REPORT

A 28 month old boy was admitted to the hospital on March 17, 1953, because of fever of ten days' duration. He had been in good health until ten days prior to admission when his temperature rose to between 102 and 103 degrees F., the lips cracked and bled, and an ill-defined rash appeared on the face and anterior chest wall. Intense pruritus developed and resulted in deep excoriations of the skin of the arms, legs and trunk. The patient complained of pain in . . .


 

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