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Chronic Vitamin A Intoxication: Report of a Case in an Older Child and Review of the Literature

Chronic Vitamin A Intoxication: Report of a Case in an Older Child and Review of the Literature Abstract Poisoning due to prolonged ingestion of high doses of vitimain A (hypervitaminosis A) in children 3 years of age and younger was first described more than a decade ago. Several cases have also been reported in adults. Recently two children beyond 3 years of age with chronic vitamin A intoxication have been reported from England. The following report describes an additional case in an older child. Report of Case A 14-year-old white girl * was admitted to The Children's Hospital on Sept. 11, 1956, with the chief complaint of leg pain of five weeks' duration. Two years prior to admission the patient developed superficial, nonpitting acne vulgaris, for which, 10 months prior to admission, 200,000 units of vitamin A daily had been prescribed by a dermatologist. Two months prior to admission she had had her last normal menstrual period, succeeding ones being at the normal interval but scanty and of one References 1. Josephs, H. W.: Hypervitaminosis A and Carotenemia , Am. J. Dis. Child. 67:33, 1944. 2. Toomey, J. A., and Morissette, R. A.: Hypervitaminosis A , Am. J. Dis. Child. 73:473, 1947. 3. Dickey, L. B., and Bradley, E. J.: Hypervitaminosis A: A Case Report , Stanford M. Bull. 6:345, 1948. 4. Rothman, P. E., and Leon, E. E.: Hypervitaminosis A: Report of 2 Cases in Infants , Radiology 51:368, 1948.Crossref 5. Caffey, J.: Chronic Poisoning Due to Excess of Vitamin A: Description of the Clinical Roentgen Manifestations in 7 Infants and Young Children , Pediatrics 5:672, 1950. 6. Berry, B. H.: Postinfantile Cortical Hyperostosis with Subdural Hematoma: Report of Case and Review of Literature , Pediatrics 6:78, 1950. 7. Fried, C. T., and Grand, M. J. H.: Hypervitaminosis A , Am. J. Dis. Child. 79:475, 1950. 8. Wyatt, T. C.; Carabello, C. A., and Fletcher, M. E.: Hypervitaminosis A: Report of a Case , J. A. M. A. 144:304, 1950.Crossref 9. Rineberg, I. E., and Gross, R. J.: Hypervitaminosis A with Infantile Cortical Hyperostosis , J. A. M. A. 146:1222, 1951.Crossref 10. Bair, G.: Chronic Vitamin A Poisoning: Report of a Case , J. A. M. A. 146:1573, 1951.Crossref 11. Clinical Case No. 623, Cortical Hyperostosis , Case Rep. Child. Mem. Hosp. , Chicago 9: 1831, 1951. 12. Gribetz, D.; Silverman, S., and Sobel, A.: Vitamin A Poisoning , Pediatrics 7:372, 1951. 13. Arena, J. M.; Sarazen, P., and Baylin, C. J.: Hypervitaminosis A , Pediatrics 8:788, 1951. 14. Naz, J. F., and Edwards, W. M.: Hypervitaminosis A: A Case Report , New England J. Med. 246:87, 1952.Crossref 15. Reyersbach, G. C.; Hanelin, J., and Joplin. R. J.: Vitamin A Intoxication: Report of a Case , New England J. Med. 246:978, 1952.Crossref 16. Goldzier, S. E.; Pisacano, J. C., and Wald, A. M.: Hypervitaminosis A , J. Pediat. 41:198, 1952.Crossref 17. Harrison, M. T., and Mercer, R. D.: Vitamin A Intoxication , Cleveland Clin. Quart. 20:424, 1953.Crossref 18. Tudor, R. B.: Chronic Vitamin A Poisoning: A Case Report , Journal-Lancet 75:372, 1955. 19. Sulzberger, M. B., and Lazar, M. P.: Hypervitaminosis A: Report of a Case in an Adult , J. A. M. A. 146:788, 1951.Crossref 20. Shaw, E. W., and Niccoli, J. Z.: Hypervitaminosis A: Report of a Case in an Adult Male , Ann. Int. Med. 39:131, 1953.Crossref 21. Bifulco, E.: Vitamin A Intoxication: Report of a Case in an Adult , New England J. Med. 248:690, 1953.Crossref 22. Gerber, A.; Raab, A. P., and Sobel, A. E.: Vitamin A Poisoning in Adults: With Description of a Case , Am. J. Med. 16:729, 1954.Crossref 23. Bloch, H. S.: Chronic Hypervitaminosis A: Report of a Probable Case in a Man , Minnesota Med. 38:627, 1955. 24. Elliott, R. A., and Dryer, R. L.: Hypervitaminosis A: Report of a Case in an Adult , J. A. M. A. 161:1157, 1956.Crossref 25. Pickup, J. D.: Hypervitaminosis A , Arch. Dis. Childhood 31:229, 1956.Crossref 26. Richards, J.: The Polar Regions , Edinburgh, Adam and Charles Black, 1861, pp. 64-71; cited by Bloch.23 27. Rodahl, K., and Moore, T.: The Vitamin A Content and Toxicity of Bear and Seal Liver , Biochem. J. 37:166, 1943. 28. Marie, J., and See, G.: Acute Hypervitaminosis A of the Infant: Its Clinical Manifestation with Benign Acute Hydrocephalus and Pronounced Bulge of Fontanel; A Clinical and Biologic Study , A. M. A. Am. J. Dis. Child. 87: 731, 1954. 29. Nieman, C., and Klein Obbink, H. J.: The Biochemistry and Pathology of Hypervitaminosis A , Vitamins & Hormones 12:69, 1954. 30. Wolbach, S. B.: Vitamin A Deficiency and Excess in Relation to Skeletal Growth , J. Bone & Joint Surg. 29:171, 1947. 31. Millen, J. W.; Woollam, D. H. M., and Lamming, G. E.: Hydrocephalus Associated with Deficiency of Vitamin A , Lancet 2:1234, 1953. 32. Bass, M. H., and Caplan, J.: Vitamin A Deficiency in Infancy , J. Pediat. 47:690, 1955. 33. Fraser, D.: Hypophosphatasia , Am. J. Med. 22:730, 1957. 34. Wheeler, W. E.: Personal communication to the author. 35. Gellis, S.: Editorial Comment, in Year Book of Pediatrics (1956-1957 Year Book Series) , Chicago, The Year Book Publishers, Inc., 1956, p. 40. 36. Caffey, J.: Infantile Cortical Hyperostoses , J. Pediat. 29:541, 1946. 37. Goodman, L. S., and Gillman, A.: The Pharmacological Basis of Therapeutics , New York, The Macmillan Company, 1955, pp. 1728-1735. 38. National Research Council Recommended Dietary Allowances, Reprint and Circular Series 129, Washington, D. C., 1948. 39. Butt, H. R.: Fat-Soluble Vitamins A, E and K , J. A. M. A. 143:236, 1950. 40. Becker, S. W., and Obermayer, M. E.: Modern Dermatology and Syphilology , Ed. 2, Philadelphia, J. B. Lippincott Company, 1947. 41. MacKenna, R. M. B.: Modern Trends in Dermatology , second series, New York, Paul B. Hoeber, Inc. (Medical Book Department of Harper & Brothers), 1954. 42. Andrews, G. C.: Diseases of the Skin , Ed. 4, Philadelphia, W. B. Saunders Company, 1954, p. 218. 43. Pillsbury, D. M.; Shelly, W. B., and Kingman, A. M.: Dermatology , Philadelphia, W. B. Saunders Company, 1956, p. 957. 44. Allen, A. C.: The Skin , New York, The C. V. Mosby Company, 1954, p. 564. 45. Cecil, R. L., and Loeb, R. F.: A Textbook of Medicine , Ed. 9, Philadelphia, W. B. Saunders Company, 1955, p. 552. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Journal of Diseases of Children American Medical Association

Chronic Vitamin A Intoxication: Report of a Case in an Older Child and Review of the Literature

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References (49)

Publisher
American Medical Association
Copyright
Copyright © 1958 American Medical Association. All Rights Reserved.
ISSN
0096-6916
DOI
10.1001/archpedi.1958.02060050059010
Publisher site
See Article on Publisher Site

Abstract

Abstract Poisoning due to prolonged ingestion of high doses of vitimain A (hypervitaminosis A) in children 3 years of age and younger was first described more than a decade ago. Several cases have also been reported in adults. Recently two children beyond 3 years of age with chronic vitamin A intoxication have been reported from England. The following report describes an additional case in an older child. Report of Case A 14-year-old white girl * was admitted to The Children's Hospital on Sept. 11, 1956, with the chief complaint of leg pain of five weeks' duration. Two years prior to admission the patient developed superficial, nonpitting acne vulgaris, for which, 10 months prior to admission, 200,000 units of vitamin A daily had been prescribed by a dermatologist. Two months prior to admission she had had her last normal menstrual period, succeeding ones being at the normal interval but scanty and of one References 1. Josephs, H. W.: Hypervitaminosis A and Carotenemia , Am. J. Dis. Child. 67:33, 1944. 2. Toomey, J. A., and Morissette, R. A.: Hypervitaminosis A , Am. J. Dis. Child. 73:473, 1947. 3. Dickey, L. B., and Bradley, E. J.: Hypervitaminosis A: A Case Report , Stanford M. Bull. 6:345, 1948. 4. Rothman, P. E., and Leon, E. E.: Hypervitaminosis A: Report of 2 Cases in Infants , Radiology 51:368, 1948.Crossref 5. Caffey, J.: Chronic Poisoning Due to Excess of Vitamin A: Description of the Clinical Roentgen Manifestations in 7 Infants and Young Children , Pediatrics 5:672, 1950. 6. Berry, B. H.: Postinfantile Cortical Hyperostosis with Subdural Hematoma: Report of Case and Review of Literature , Pediatrics 6:78, 1950. 7. Fried, C. T., and Grand, M. J. H.: Hypervitaminosis A , Am. J. Dis. Child. 79:475, 1950. 8. Wyatt, T. C.; Carabello, C. A., and Fletcher, M. E.: Hypervitaminosis A: Report of a Case , J. A. M. A. 144:304, 1950.Crossref 9. Rineberg, I. E., and Gross, R. J.: Hypervitaminosis A with Infantile Cortical Hyperostosis , J. A. M. A. 146:1222, 1951.Crossref 10. Bair, G.: Chronic Vitamin A Poisoning: Report of a Case , J. A. M. A. 146:1573, 1951.Crossref 11. Clinical Case No. 623, Cortical Hyperostosis , Case Rep. Child. Mem. Hosp. , Chicago 9: 1831, 1951. 12. Gribetz, D.; Silverman, S., and Sobel, A.: Vitamin A Poisoning , Pediatrics 7:372, 1951. 13. Arena, J. M.; Sarazen, P., and Baylin, C. J.: Hypervitaminosis A , Pediatrics 8:788, 1951. 14. Naz, J. F., and Edwards, W. M.: Hypervitaminosis A: A Case Report , New England J. Med. 246:87, 1952.Crossref 15. Reyersbach, G. C.; Hanelin, J., and Joplin. R. J.: Vitamin A Intoxication: Report of a Case , New England J. Med. 246:978, 1952.Crossref 16. Goldzier, S. E.; Pisacano, J. C., and Wald, A. M.: Hypervitaminosis A , J. Pediat. 41:198, 1952.Crossref 17. Harrison, M. T., and Mercer, R. D.: Vitamin A Intoxication , Cleveland Clin. Quart. 20:424, 1953.Crossref 18. Tudor, R. B.: Chronic Vitamin A Poisoning: A Case Report , Journal-Lancet 75:372, 1955. 19. Sulzberger, M. B., and Lazar, M. P.: Hypervitaminosis A: Report of a Case in an Adult , J. A. M. A. 146:788, 1951.Crossref 20. Shaw, E. W., and Niccoli, J. Z.: Hypervitaminosis A: Report of a Case in an Adult Male , Ann. Int. Med. 39:131, 1953.Crossref 21. Bifulco, E.: Vitamin A Intoxication: Report of a Case in an Adult , New England J. Med. 248:690, 1953.Crossref 22. Gerber, A.; Raab, A. P., and Sobel, A. E.: Vitamin A Poisoning in Adults: With Description of a Case , Am. J. Med. 16:729, 1954.Crossref 23. Bloch, H. S.: Chronic Hypervitaminosis A: Report of a Probable Case in a Man , Minnesota Med. 38:627, 1955. 24. Elliott, R. A., and Dryer, R. L.: Hypervitaminosis A: Report of a Case in an Adult , J. A. M. A. 161:1157, 1956.Crossref 25. Pickup, J. D.: Hypervitaminosis A , Arch. Dis. Childhood 31:229, 1956.Crossref 26. Richards, J.: The Polar Regions , Edinburgh, Adam and Charles Black, 1861, pp. 64-71; cited by Bloch.23 27. Rodahl, K., and Moore, T.: The Vitamin A Content and Toxicity of Bear and Seal Liver , Biochem. J. 37:166, 1943. 28. Marie, J., and See, G.: Acute Hypervitaminosis A of the Infant: Its Clinical Manifestation with Benign Acute Hydrocephalus and Pronounced Bulge of Fontanel; A Clinical and Biologic Study , A. M. A. Am. J. Dis. Child. 87: 731, 1954. 29. Nieman, C., and Klein Obbink, H. J.: The Biochemistry and Pathology of Hypervitaminosis A , Vitamins & Hormones 12:69, 1954. 30. Wolbach, S. B.: Vitamin A Deficiency and Excess in Relation to Skeletal Growth , J. Bone & Joint Surg. 29:171, 1947. 31. Millen, J. W.; Woollam, D. H. M., and Lamming, G. E.: Hydrocephalus Associated with Deficiency of Vitamin A , Lancet 2:1234, 1953. 32. Bass, M. H., and Caplan, J.: Vitamin A Deficiency in Infancy , J. Pediat. 47:690, 1955. 33. Fraser, D.: Hypophosphatasia , Am. J. Med. 22:730, 1957. 34. Wheeler, W. E.: Personal communication to the author. 35. Gellis, S.: Editorial Comment, in Year Book of Pediatrics (1956-1957 Year Book Series) , Chicago, The Year Book Publishers, Inc., 1956, p. 40. 36. Caffey, J.: Infantile Cortical Hyperostoses , J. Pediat. 29:541, 1946. 37. Goodman, L. S., and Gillman, A.: The Pharmacological Basis of Therapeutics , New York, The Macmillan Company, 1955, pp. 1728-1735. 38. National Research Council Recommended Dietary Allowances, Reprint and Circular Series 129, Washington, D. C., 1948. 39. Butt, H. R.: Fat-Soluble Vitamins A, E and K , J. A. M. A. 143:236, 1950. 40. Becker, S. W., and Obermayer, M. E.: Modern Dermatology and Syphilology , Ed. 2, Philadelphia, J. B. Lippincott Company, 1947. 41. MacKenna, R. M. B.: Modern Trends in Dermatology , second series, New York, Paul B. Hoeber, Inc. (Medical Book Department of Harper & Brothers), 1954. 42. Andrews, G. C.: Diseases of the Skin , Ed. 4, Philadelphia, W. B. Saunders Company, 1954, p. 218. 43. Pillsbury, D. M.; Shelly, W. B., and Kingman, A. M.: Dermatology , Philadelphia, W. B. Saunders Company, 1956, p. 957. 44. Allen, A. C.: The Skin , New York, The C. V. Mosby Company, 1954, p. 564. 45. Cecil, R. L., and Loeb, R. F.: A Textbook of Medicine , Ed. 9, Philadelphia, W. B. Saunders Company, 1955, p. 552.

Journal

A.M.A. Journal of Diseases of ChildrenAmerican Medical Association

Published: Jan 1, 1958

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