Not a Benign Vitamin: Infant with Vitamin A Toxicity and Acute Intracranial Hypertension

Lagacé, Micheline; Oskoui, Maryam; Myers, Kenneth A.

doi:10.1017/cjn.2022.335

Cited by 2 publications

(2 citation statements)

References 8 publications

(42 reference statements)

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“…Children aged one to three years should receive 400 μg retinol equivalents (RE) daily, with a maximum of 800 μg RE/day. Acute hypervitaminosis A has been reported with acute ingestion of 20 to 100 times the RDA [ 8 ]. In our case, the parents supplemented their daughter's diet with the liver of tuna rich in vitamin A, believing that this would strengthen her immune system.…”

Section: Discussionmentioning

confidence: 99%

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A Rare Case Report of Benign Intracranial Hypertension Caused by Hypervitaminosis A

Hajaj,

Ghanam,

Zahiri

et al. 2024

Cureus

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Benign intracranial hypertension (BIH) in children is recognized as elevated intracranial pressure without hydrocephalus or intracranial mass. It manifests differently in adults, with no apparent predilection for sex or weight. Headache, papilledema, and possibly sixth nerve palsy with visual field defects are the typical symptoms of this syndrome. Vitamin A toxicity is a rare cause of BIH. We report the case of a previously healthy 13-year-old girl presenting with photophobia, a frontal headache, and vomiting. She had bilateral papilledema discovered by fundoscopy. Both magnetic resonance imaging and brain CT were normal. At admission, a lumbar puncture (LP) revealed an opening pressure of 26 cm H 2 O with normal cerebrospinal fluid (CSF) analysis. The diagnosis of BIH was established, and treatment with acetazolamide was started, with good clinical results. Regular eye evaluations showed a regression of papilledema. Elevated serum vitamin A levels were the only positive findings. Within two weeks, the patient was discharged without any symptoms.This study aims to attract the attention of clinicians to the importance of evaluating vitamin A toxicity in the context of papilledema and oculomotor problems in a child who has undergone normal neuroradiological investigations.

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Section: Discussionmentioning

confidence: 99%

“…The treatment of acute vitamin A toxicity involves monitoring for indicators of intracranial hypertension, hydration, and stopping exposure. Acetazolamide may also have a direct impact on the metabolism of vitamin A [ 8 ].…”

Section: Discussionmentioning

confidence: 99%