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Fatal hypervitaminosis A in a neonate
Archives of Pathology & Laboratory Medicine
|October 1, 1984
Summary
Fatal hypervitaminosis A is rare. A neonate died from excessive vitamin A intake, experiencing hypercalcemia, bleeding, and lung issues, with widespread calcifications found post-mortem.
Area of Science:
- Toxicology
- Pediatric Medicine
- Biochemistry
Background:
- Hypervitaminosis A, while not uncommon, rarely results in fatalities.
- Neonatal cases of severe vitamin A toxicity are exceptionally rare.
Observation:
- A neonate ingested vitamin A at over 60 times the recommended daily dose for 11 consecutive days.
- The infant presented with severe hypercalcemia, hyperphosphatemia, a bleeding disorder, and pulmonary insufficiency.
Findings:
- Autopsy revealed extensive calcifications in the lungs (alveolar septa, bronchioles).
- Metastatic calcifications were observed in kidneys, stomach, soft tissues, and skin.
- Skeletal examination showed altered endochondral bone formation and accelerated bone resorption.
Implications:
- This case highlights the potential for lethal outcomes from acute, massive vitamin A overdose in neonates.
- Accelerated bone resorption and subsequent hypercalcemia leading to metastatic calcification are key pathological features.
- Understanding these mechanisms is crucial for managing vitamin A toxicity in infants.