hypervitaminosis A
School ager
with a dietary surplus. AP radiograph of the bilateral femurs (above) shows diffuse periosteal reaction along the lateral borders of the femoral diaphyses, left greater than right. Lateral radiograph of the forearm (below) shows dense periosteal reaction along the posterior aspect of the ulna.The diagnosis was hypervitaminosis A.
Hypervitaminosis A results from an excess of vitamin A. It usually manifests in children, and one recognized 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
Chronic
- pruritus, dry skin, dry lips
- soft tissue nodules
- diffuse symmetric periostitis (scintigraphy may allow earlier detection )
- may cause premature fusion of ossification centers
- separation of cranial sutures
- hepatosplenomegaly
- tendinous/ligamentous calcifications
Differential diagnosis
- infantile cortical hyperostosis (Caffey disease): for skeletal manifestations
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