Vitamin A hepatotoxicity in multiple family members

Three of five family members experienced symptoms and biochemical evidence of hepatitis that could not be explained on the basis of infectious, metabolic or immunologic disorders of the liver. A history of prolonged ingestion of moderate amounts of vitamin A (20,000 to 45,000 IU per day for 7 to 10 years) was obtained in each of the three family members and was absent in the remaining two unaffected individuals. A liver biopsy performed in one family member confirmed the diagnosis of vitamin A toxicity. This report emphasizes the finding that even moderate amounts of vitamin A, when ingested over a prolonged period of time, can cause significant hepatocellular injury.