Rosenberg H K, Berezin S, Heyman S, Witzleben C, Watkins J B
Clin Pediatr (Phila). 1982 Jul;21(7):435-40. doi: 10.1177/000992288202100710.
The usual presenting features of vitamin A intoxication are pseuotumor cerebri, skeletal pain, desquamative dermatitis, and hepatic inflammation. Our patient was a nine-year-old female who had increasing cough, dyspnea, and abdominal distention for a short time prior to admission. She was said to have been treated with 10,000 units of vitamin A per day for skin rashes. Radiographic studies revealed a very large right sided pleural effusion, ascites, demineralized bones, and retarded skeletal maturation. The diagnosis of hypervitaminosis A was made. More detailed medical history confirmed that the child had, in actuality, received up to 300,000 units/day of vitamin A plus desiccated liver pills and carrot juice for the previous year. Clinical symptoms completely abated following acute medical treatment for ascites and cessation of vitamin A intake. Several months later, a sample of liver, obtained and preserved at the time of exploratory laparotomy, was homogenized and extracted with ethanol/hexane. The retinyl palmitate level was significantly elevated and consistent with vitamin A poisoning.
维生素A中毒的常见表现为假性脑瘤、骨骼疼痛、剥脱性皮炎和肝脏炎症。我们的患者是一名9岁女性，入院前短时间内咳嗽、呼吸困难和腹胀症状加重。据说她因皮疹每天接受10,000单位维生素A治疗。影像学检查显示右侧胸腔积液、腹水、骨质脱矿和骨骼发育迟缓。诊断为维生素A过多症。更详细的病史证实，实际上该儿童在前一年每天摄入高达300,000单位的维生素A，外加干肝片和胡萝卜汁。在对腹水进行急性治疗并停止摄入维生素A后，临床症状完全缓解。几个月后，在剖腹探查时获取并保存的肝脏样本用乙醇/己烷匀浆并提取。棕榈酸视黄酯水平显著升高，与维生素A中毒相符。
