Clinical Quiz

    August 2005 in “ Journal of Pediatric Gastroenterology and Nutrition ”
    Ruba Azzam, Kimberley Dilley, Héctor Melín‐Aldana, Estella M. Alonso, Timothy Sentongo
    TLDR The toddler's health issues were caused by too much vitamin A from supplements.
    A 29-month-old male toddler presented with symptoms including balance issues, language regression, and hair loss, which were ultimately diagnosed as chronic vitamin A intoxication. The child had been on a gluten-free diet supplemented with vitamin drops containing excessive vitamin A (15,000-75,000 IU/day) for 16 months, far exceeding the recommended intake of 1,200-1,600 IU/day for his age. Symptoms of vitamin A intoxication included alopecia, skin issues, hepatomegaly, and anemia. Diagnosis was confirmed by liver biopsy showing Ito cell hyperplasia. Management involved stopping vitamin A supplements and restricting vitamin A-rich foods, with recovery expected to take several months due to the long half-life of vitamin A.
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