Massive vitamin A intoxication with ascites and pleural effusion.

Abstract:

:Vitamin A intoxication was diagnosed in a 14-year-old girl who presented with massive exudative ascites and right pleural effusion, impaired liver enzymes, and hypertriglyceridemia. Electron microscopy of liver biopsy material demonstrated numerous perisinusoidal lipid-filled Ito cells. The patient had taken 100-200,000 I.U. vitamin A per day for 15 months. Serum vitamin A level remained elevated for 4 months after vitamin discontinuation. The unusual severity of portal hypertension was documented by a high wedged hepatic vein pressure level. The ascites occurred 2 months after vitamin A had been discontinued, probably owing to particularly slow mobilization of large hepatic stores of vitamin A. Portal hypertension disappeared after a 6-month low vitamin A diet, but the liver biopsy failed to demonstrate any decrease in number or size of Ito cells, suggesting that lipid venous obstruction is unlikely to be the only mechanism responsible for portal hypertension in vitamin A-induced liver disease.

journal_name

J Clin Gastroenterol

authors

Noseda A,Adler M,Ketelbant P,Baran D,Winand J

doi

10.1097/00004836-198508000-00016

subject

Has Abstract

pub_date

1985-08-01 00:00:00

pages

344-9

issue

4

eissn

0192-0790

issn

1539-2031

journal_volume

7

pub_type

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