Reversible hepatotoxicity associated with hepatic vitamin A accumulation in a protein-deficient patient

Weber, Fredrick L.; Mitchell, G. E.; Powell, Deborah E.; Reiser, Barbara J.; Banwell, John G.

doi:10.1016/0016-5085(82)90132-9

Cited by 35 publications

(12 citation statements)

References 23 publications

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“…A similar case was reported by Noseda et al (13). Others (24) found no changes in collagen content of the liver in a patient 12 weeks after cessation of vitamin A intake.…”

Section: Discussionsupporting

confidence: 84%

Vitamin A abuse: development of cirrhosis despite cessation of vitamin A. A six‐year clinical and histopathologic follow‐up

Michielsen

Pelckmans

Fevery

et al. 1992

Liver

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ABSTRACT— We report the case of a 35‐year‐old man who contracted vitamin A‐induced liver cirrhosis. Five years before, he had been investigated for vitamin A‐induced non‐cirrhotic portal hypertension. In this case, the clinical and histopathologic evolution from non‐cirrhotic portal hypertension to cirrhosis was documented. In spite of the cessation of pharmaceutical vitamin A intake, the disease progressed. Therapy with colchicine and phenobarbital apparently did not influence evolution to cirrhosis. This suggests that vitamin A can trigger largely unknown mechanisms of liver fibrosis which seem to be self‐perpetuating.

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“…A similar case was reported by Noseda et al (13). Others (24) found no changes in collagen content of the liver in a patient 12 weeks after cessation of vitamin A intake.…”

Section: Discussionsupporting

confidence: 84%

Vitamin A abuse: development of cirrhosis despite cessation of vitamin A. A six‐year clinical and histopathologic follow‐up

Michielsen

Pelckmans

Fevery

et al. 1992

Liver

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“…Recent dietary and/or supplemental intakes can cause an increase in circulating retinyl esters, which can last for 3–5 h after a meal (depending on the nature of the meal that was ingested). Protein malnutrition (300), liver disease (301), and hypertriglyceridemia (297) can all result in high circulating retinyl ester values even when vitamin A status is normal. Finally, old age alone can result in impaired clearance of retinyl esters from chylomicron circulation after a meal, and thus result in higher blood retinyl ester concentrations for longer periods of time after eating than in young adults (302).…”

Section: Biomarker-specific Issuesmentioning

confidence: 99%

Biomarkers of Nutrition for Development (BOND)—Vitamin A Review

Tanumihardjo

Russell

Stephensen

et al. 2016

The Journal of Nutrition

358

414

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The Biomarkers of Nutrition for Development (BOND) project is designed to provide evidence-informed advice to anyone with an interest in the role of nutrition in health. The BOND program provides information with regard to selection, use, and interpretation of biomarkers of nutrient exposure, status, function, and effect, which will be especially useful for readers who want to assess nutrient status. To accomplish this objective, expert panels are recruited to evaluate the literature and to draft comprehensive reports on the current state of the art with regard to specific nutrient biology and available biomarkers for assessing nutritional status at the individual and population levels. Phase I of the BOND project includes the evaluation of biomarkers for 6 nutrients: iodine, folate, zinc, iron, vitamin A, and vitamin B-12. This review of vitamin A is the current article in this series. Although the vitamin was discovered >100 y ago, vitamin A status assessment is not trivial. Serum retinol concentrations are under homeostatic control due in part to vitamin A’s use in the body for growth and cellular differentiation and because of its toxic properties at high concentrations. Furthermore, serum retinol concentrations are depressed during infection and inflammation because retinol-binding protein (RBP) is a negative acute-phase reactant, which makes status assessment challenging. Thus, this review describes the clinical and functional indicators related to eye health and biochemical biomarkers of vitamin A status (i.e., serum retinol, RBP, breast-milk retinol, dose-response tests, isotope dilution methodology, and serum retinyl esters). These biomarkers are then related to liver vitamin A concentrations, which are usually considered the gold standard for vitamin A status. With regard to biomarkers, future research questions and gaps in our current understanding as well as limitations of the methods are described.

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“…He had consumed up to 25 000 IU/day of the vitamin for seven years and had a degree of protein-energy malnutrition as a result of a poor diet. 29 Despite having the highest vitamin A absorption parameters, patient 9 ranked only 4th, 3rd, and 2nd for plasma retinol, carotenes, and serum retinol binding proteins concentrations respectively. Animal studies suggest that over supplementation may also suppress retinol binding proteins synthesis,3' thus further complicating the situation.…”

Section: Discussionmentioning

confidence: 94%

“…Nine adult cystic fibrosis patients (seven men; median age 22 years (range [16][17][18][19][20][21][22][23][24][25][26][27][28][29]) and six control subjects (three men; median age 27 years (range 19-30)) took part in the study. All cystic fibrosis patients had been taking regular vitamin A supplements and all but one used pancreatic enzyme supplements regularly.…”

Section: Subjects and Samplesmentioning

confidence: 99%