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Vitamin A-induced cholestatic hepatitis: a case report
P Becker1, B Maurer, P Schirmacher
1Department of Medicine, Salem Medical Center, Heidelberg.
Zeitschrift Fur Gastroenterologie
|October 10, 2007
Summary
Chronic vitamin A supplementation caused intrahepatic cholestasis in a 70-year-old woman. Treatment with ursodeoxycholic acid led to a full recovery, highlighting the risks of excessive vitamin A intake.
Area of Science:
- Hepatology
- Toxicology
- Oncology
Background:
- A 70-year-old woman with a history of breast and ovarian cancer developed jaundice and cholestasis.
- Chemotherapy for cancer was completed one month prior to the onset of liver abnormalities.
Observation:
- The patient received weekly injections of 100,000 IU vitamin A as supportive care post-chemotherapy.
- Liver biopsy revealed acute toxic liver injury, including necrosis, sinusoidal lesions, inflammation, and stellate cell activation.
Findings:
- Elevated hepatic vitamin A concentrations confirmed vitamin A toxicity.
- Cholestasis and jaundice were the primary clinical manifestations.
- No signs of intrahepatic metastasis or liver cirrhosis were present.
Implications:
- Excessive vitamin A supplementation can lead to severe intrahepatic cholestasis and toxic liver injury.
- Prompt diagnosis and cessation of the offending agent are crucial for recovery.
- Ursodeoxycholic acid demonstrated efficacy in treating vitamin A-induced cholestasis.
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