Hypervitaminosis A

Changed by Henry Knipe, 7 Jun 2022

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Disclosures - updated 6 Apr 2022:

Radiopaedia Events Pty Ltd, Speaker fees (past)
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Hypervitaminosis A results from an excess of vitamin A. It usually manifests in children, and one recognised cause is administration from 13-cis retinoic acid for treatment of cancers such as neuroblastoma.

Clinical presentation

Manifestations can differ depending on whether it is an acute or chronic excess of vitamin A.

Acute

pseudotumour cerebri

Chronic

pruritus, dry skin, dry lips
soft tissue nodules
diffuse symmetric periostitis (scintigraphy may allow earlier detection ²)
may cause premature fusion of ossification centres
separation of cranial sutures
hepatosplenomegaly
tendinous/ligamentous calcifications

Differential diagnosis

infantile cortical hyperostosis (Caffey disease): for skeletal manifestations

~~-<li>diffuse symmetric <a title="Periostitis" href="/articles/periosteal-reaction">periostitis</a> (scintigraphy may allow earlier detection <sup>2</sup>)</li>~~
+<li>diffuse <a title="Symmetrical periosteal reaction" href="/articles/symmetrical-periosteal-reaction">symmetric periostitis</a> (scintigraphy may allow earlier detection <sup>2</sup>)</li>
~~-<li><a title="Hepatosplenomegaly" href="/articles/hepatosplenomegaly">hepatosplenomegaly</a></li>~~
+<li><a href="/articles/hepatosplenomegaly">hepatosplenomegaly</a></li>

References changed:

1. Miller J & Hayon I. Bone Scintigraphy in Hypervitaminosis A. AJR Am J Roentgenol. 1985;144(4):767-8. <a href="https://doi.org/10.2214/ajr.144.4.767">doi:10.2214/ajr.144.4.767</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/3872035">Pubmed</a>
2. Pennes D, Ellis C, Madison K, Voorhees J, Martel W. Early Skeletal Hyperostoses Secondary to 13-Cis-Retinoic Acid. AJR Am J Roentgenol. 1984;142(5):979-83. <a href="https://doi.org/10.2214/ajr.142.5.979">doi:10.2214/ajr.142.5.979</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/6609585">Pubmed</a>
1. Miller JH, Hayon II. Bone scintigraphy in hypervitaminosis A. AJR Am J Roentgenol. 1985;144 (4): 767-8. <a href="http://www.ajronline.org/cgi/content/citation/144/4/767">AJR Am J Roentgenol (citation)</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/3872035">Pubmed citation</a><div class="ref_v2"></div>
2. Pennes DR, Ellis CN, Madison KC et-al. Early skeletal hyperostoses secondary to 13-cis-retinoic acid. AJR Am J Roentgenol. 1984;142 (5): 979-83. <a href="http://www.ajronline.org/cgi/content/abstract/142/5/979">AJR Am J Roentgenol (abstract)</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/6609585">Pubmed citation</a><div class="ref_v2"></div>