Hypervitaminosis A inducing intra-hepatic cholestasis--a rare case report.

Abstract

The use of over-the-counter supplements is commonplace in today's health conscious society. We present an unusual case of intrahepatic cholestasis caused by vitamin A intoxication. The patient consumed one Herbalife shake with two multivitamin tablets of the same brand for 12 years. When calculated this equated to more than the recommended daily allowance for vitamin A consumption. Deranged liver function tests were consistent with a cholestatic process. Liver biopsy was obtained and revealed features pathognomonic of vitamin A toxicity, without the usual fibrosis. When the supplements were ceased, his jaundice and alkaline phosphatase completely normalized. This case highlights the importance of health care providers documenting non-prescribed dietary supplements and considering them in the etiology of cholestatic liver disease.

• Authors: Vivek S Ramanathan, Gary Hensley, Samuel French, Victor Eysselein, David Chung, Sonya Reicher, Binh Pham
• Journal: Experimental and molecular pathology (Exp Mol Pathol) Vol. 88 Issue 2 Pg. 324-5 (Apr 2010) ISSN: 1096-0945 [Electronic] Netherlands
• PMID: 19944093 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright 2009 Elsevier Inc. All rights reserved.

Chemical References

• Herbalife
• Vitamins
• Vitamin A

Topics

• Cholestasis, Intrahepatic (chemically induced, etiology, pathology)
• Ephedra (toxicity)
• Humans
• Hypervitaminosis A (complications, pathology)
• Jaundice (chemically induced, etiology, pathology)
• Male
• Middle Aged
• Pruritus (chemically induced, etiology, pathology)
• Vacuoles (pathology, ultrastructure)
• Vitamin A (toxicity)
• Vitamins