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Hypervitaminosis A

Medha Mittal, Vineeta Yadav, Rajesh Khadgawat, Manish Kumar, Poonam Sherwani
Aim: To compare efficacy and safety of 90,000 IU versus 300,000 IU oral single dose vitamin D for treatment of nutritional rickets. Study Design: Randomized controlled trial. Setting: Tertiary care hospital. Participants: One hundred ten children (6 months to 5 years, median age 10.5 months) with rickets. Exclusion criteria were disease affecting absorption, intake of calcium/vitamin D preparation in last 6 months, abnormal renal function, and rickets other than nutritional...
November 2018: Indian Journal of Endocrinology and Metabolism
Vikte Lionikaite, Petra Henning, Christina Drevinge, Furqan A Shah, Anders Palmquist, Pernilla Wikström, Sara H Windahl, Ulf H Lerner
Increased vitamin A consumption is associated with decreased cortical bone mass and increased fracture risk in humans. Rodent studies have demonstrated that hypervitaminosis A increases cortical bone resorption, whereas the importance of the effects on bone formation is less well defined. We used an experimental model of increased bone formation by loading of the tibiae to investigate the effect of vitamin A on bone formation. Control [retinol activity equivalents (RAE) 4.5 µg/g chow] or vitamin A (RAE 60 µg/g chow) diets were given to female C57BL/6N mice for 4 wk, after which the tibiae were subjected to axial loading on alternate days for 2 wk, while the diets were continued...
January 22, 2019: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
P G Muñoz, A M Santiago, C B Bellido, C C Franco, J M Á Martínez, L M M Gómez, G S Artacho, J M C Tuñón, L N Morales, F J P Ruíz, M Á G Bravo
Herein we report a case of liver dysfunction caused by consumption of vitamin A supplements leading to liver transplantation. The patient was a 48-year-old male with a medical history of congenital ichthyosiform erythroderma in treatment with vitamin A until 12 years of age, at which point he discontinued the supplements because he had developed ascites. Liver cirrhosis was diagnosed as secondary to hypervitaminosis A on the basis of histologic examination of liver biopsy and the absence of other potential causes of chronic liver disease...
January 14, 2019: Transplantation Proceedings
Katherine G Doyle, Mercedes M Blackstone, Brett C Barrett
We present a case of a 20-month-old girl who presented to the emergency department with anorexia, progressive weakness, and lethargy who was found to have severe hypercalcemia (20.7 mg/dL) and vitamin D hypervitaminosis. Further questioning revealed that this was secondary to a subacute toxic ingestion of "L'il Critters" calcium and vitamin D3 gummy vitamins that were being administered by the patient's mother multiple times a day for several weeks or even months. This occurred in the setting of child neglect due to the mother's mental illness...
January 7, 2019: Pediatric Emergency Care
Luciana S Carmo, Emmanuel A Burdmann, Melissa R Fessel, Youri E Almeida, Luciana Alves Pescatore, Elisangela Farias-Silva, Lionel F Gamarra, Gabriel H Lopes, Thiago P A Aloia, Marcel Liberman
Objective- We hypothesized that ob/ob mice develop expansive vascular remodeling associated with calcification. Approach and Results- We quantified and investigated mechanisms of vascular remodeling and vascular calcification in ob/ob mice after vitamin D3 (VD) stimulation or PBS (CT), compared with C57BL/6 mice. Both ob/ob (OBVD [VD-treated ob/ob mice]) and C57BL/6 (C57VD [VD-treated C57BL/6 mice]) received 8×103 IU/day of intraperitoneal VD for 14 days. Control ob/ob (OBCT [PBS-treated ob/ob mice]) and C57BL/6 (C57CT [PBS-treated C57BL/6 mice]) received intraperitoneal PBS for 14 days...
November 8, 2018: Arteriosclerosis, Thrombosis, and Vascular Biology
Manjunath Havalappa Dodamani, Valliappan Muthu, Reetu Thakur, Arnab Pal, Inderpaul Singh Sehgal, Sahajal Dhooria, Ashutosh N Aggarwal, Mandeep Garg, Arunaloke Chakrabarti, Ritesh Agarwal
Vitamin D has been demonstrated to have an immunomodulatory role in cystic fibrosis with allergic bronchopulmonary aspergillosis (ABPA). Herein, we evaluate supplemental vitamin D in acute-stage ABPA complicating asthma. Thirty subjects were randomized to receive either prednisolone (n=15, control) or prednisolone and oral vitamin D (n=15, intervention arm). Serum vitamin D levels were significantly higher in the intervention versus the control arm, following therapy. The mean decline in total IgE at two months (primary outcome) was 10% higher in the intervention arm than the control arm; however, this was not statistically significant (48...
December 18, 2018: Mycoses
Pedro Xavier-Elsas, Bruno Marques Vieira, Daniela Masid-de-Brito, Monica Gomes Barradas, Maria Ignez C Gaspar-Elsas
Vitamin A and its derivatives (retinoids) act as potent regulators in many aspects of mammalian reproduction, development, repair, and maintenance of differentiated tissue functioning. Unlike other vitamins, Vitamin A and retinoids, which have hormonal actions, present significant toxicity, which plays roles in clinically relevant situations, such as hypervitaminosis A and retinoic acid ("differentiation") syndrome. Although clinical presentation is conspicuous in states of insufficient or excessive Vitamin A and retinoid concentration, equally relevant effects on host resistance to specific infectious agents, and in the general maintenance of immune homeostasis, may go unnoticed, because their expression requires either pathogen exposure or the presence of inflammatory co-morbidities...
December 16, 2018: Current Drug Targets
Martin Kaufmann, Corine Martineau, Alice Arabian, Mary Traynor, René St-Arnaud, Glenville Jones
Calcitroic acid, the excretory form of vitamin D, is the terminal product of a 5-step pathway catalyzed by CYP24A1, commencing with C24-hydroxylation of 1,25-dihydroxyvitamin D3 (1,25-(OH)2 D3 ). Catabolism of 25-hydroxyvitamin D3 (25-OH-D3 ) proceeds via analogous steps culminating in calcioic acid; however this C23-truncated acid has not been reported in the circulation. It has recently been shown that 24,25-dihydroxyvitamin D3 (24,25-(OH)2 D3 ) is an important factor in optimal bone fracture healing acting via an effector molecule FAM57B2 to produce lactosylceramide...
December 13, 2018: Journal of Steroid Biochemistry and Molecular Biology
Kiersten Olsen, Devika J Suri, Christopher Davis, Jesse Sheftel, Kohei Nishimoto, Yusuke Yamaoka, Yutaka Toya, Nathan V Welham, Sherry A Tanumihardjo
Background: Minimal human data exist on liver vitamin A (VA) compared with serum biomarkers. Cutoffs of 5% and 10% total serum VA as retinyl esters (REs) suggest a VA intoxication diagnosis. Objectives: We compared total liver VA reserves (TLRs) with the percentage of total serum VA as REs to evaluate hypervitaminosis with the use of US adult autopsy samples. Secondary objectives evaluated serum retinol sensitivity, TLRs among lobes, and hepatic α-retinol concentrations, an α-carotene cleavage product...
November 1, 2018: American Journal of Clinical Nutrition
Isaiah Tan, Laurie Lomasney, Gregory Scott Stacy, Martin Lazarus, Winnie Anne Mar
OBJECTIVE: Voriconazole is an antifungal medication used primarily for the treatment of Candida and Aspergillus infections. A fairly newly described side effect of long-term voriconazole use is periostitis. The purpose of this article is to describe the main differential consideration-hypertrophic osteoarthropathy-and other differential diagnoses, including venous stasis, thyroid acropachy, and hypervitaminosis A. CONCLUSION: With knowledge of imaging appearance, clinical manifestations, and outcomes, radiologists can make an accurate diagnosis of voriconazole-induced periostitis, and clinical teams can initiate appropriate management...
November 7, 2018: AJR. American Journal of Roentgenology
Thawee Songpatanasilp, Sattaya Rojanasthien, Pansak Sugkraroek, Boonsong Ongphiphadhanakul, Lamar Robert, Chongchit Sripun Robert, Sirichai Luevitoonvechkij, Arthur C Santora
BACKGROUND: It is generally believed that Thai people do not suffer from hypovitaminosis D because there is abundant sunlight throughout the year, and that taking vitamin D supplements could result in abnormally high levels of vitamin D. This is a Thai FDA-driven study to investigate this risk over a period of 26 weeks of taking alendronate sodium/vitamin D3 combination tablets. METHODS: Osteoporosis patients in Thailand were recruited to a multicenter, open-label, 6-month trial of oral alendronate sodium 70 mg/vitamin D3 5600 IU...
November 6, 2018: BMC Musculoskeletal Disorders
Andrius Bleizgys, Jevgenij Kurovskij
Aim : Data on the prevalence of vitamin D deficiency in Lithuania are scarce. The aim was to assess the reserves of vitamin D in different age groups of out-patients, regarding the season of the year. Methods : Data on serum 25-hydroxyvitamin D (25(OH)D) levels from blood tests made in 2012⁻2014 were obtained from one laboratory, and a retrospective cross-sectional analysis was performed. Results : A total of 9581 subjects were included. The mean age of the participants was 33 ± 23 years. The mean levels of vitamin D were higher in males than in females ( p < 0...
April 26, 2018: Medicina
Kentaro Ueda, Fumiko Akashi, Motoki Kawasaki, Tohru Matsui
Feed intake and body weight are drastically altered in penguins during peri-molting period, and molting is known to affect the nutritional status of vitamin A and E. Although vitamin D status is not known in penguins during peri-molting period, vitamin D intake is supposed to be remarkably altered. The objective of the present study was to clarify the alterations in plasma 25-hydroxyvitamin D (25(OH)D) concentration, the most reliable biomarker for assessing vitamin D status, and vitamin D intake during peri-molting period...
October 9, 2018: Comparative Biochemistry and Physiology. Part A, Molecular & Integrative Physiology
Malachi J McKenna, Barbara Murray, Rachel K Crowley, Patrick J Twomey, Mark T Kilbane
Serum 25-hydroxyvitamin D (25OHD) is the pre-eminent estimate of vitamin D status that we have been measuring in a hospital laboratory setting since the 1970s. We previously evaluated the trend in 25OHD results in our laboratory from 1993 to 2013. Using a time series analysis of monthly average 25OHD results the trend was modelled, and this was used to forecast monthly average 25OHD from 2014 to 2016. In this study, all 25OHD results from 2014 to 2016 were retrieved (n = 67,922) and trimmed to 40,307 results after duplicates were excluded...
February 2019: Journal of Steroid Biochemistry and Molecular Biology
Ewa Marcinowska-Suchowierska, Małgorzata Kupisz-Urbańska, Jacek Łukaszkiewicz, Paweł Płudowski, Glenville Jones
Confusion, apathy, recurrent vomiting, abdominal pain, polyuria, polydipsia, and dehydration are the most often noted clinical symptoms of vitamin D toxicity (VDT; also called vitamin D intoxication or hypervitaminosis D). VDT and its clinical manifestation, severe hypercalcemia, are related to excessive long-term intake of vitamin D, malfunctions of the vitamin D metabolic pathway, or the existence of coincident disease that produces the active vitamin D metabolite locally. Although VDT is rare, the health effects can be serious if it is not promptly identified...
2018: Frontiers in Endocrinology
Sherry A Tanumihardjo, Chisela Kaliwile, Erick Boy, Muhammad A Dhansay, Martha E van Stuijvenberg
Vitamin A (VA) deficiency is a serious public health problem, especially in preschool children who are at risk of increased mortality. In order to address this problem, the World Health Organization recommends periodic high-dose supplementation to children 6-59 months of age in areas of highest risk. Originally, supplementation was meant as a short-term solution until more sustainable interventions could be adopted. Currently, many countries are fortifying commercialized common staple and snack foods with retinyl palmitate...
September 28, 2018: Annals of the New York Academy of Sciences
Robin George Manappallil, Sudhin Shylendran, Aryasree Kakkattil, Archana Della Thomas
Renal stone disease is a common and painful condition. Even though it is rarely fatal, patients describe it as the worst pain in their life. While dietary calcium may decrease the risk of stone formation, patients on supplemental calcium are at higher risk. Moreover, patients with diabetes are more prone to develop renal calculi. Hypervitaminosis D is a rare cause of hypercalcaemia. This is a case of an elderly diabetic man who developed multiple calcium oxalate renal stones due to hypercalcaemia following calcium-vitamin D supplementation...
August 20, 2018: BMJ Case Reports
Sebastien Ellis, Georgios Tsiopanis, Tanuj Lad
Vitamin D is a fat-soluble vitamin essential for calcium homeostasis and bone health. Vitamin D toxicity or hypervitaminosis D is extremely rare. We describe the case of a 73-year-old man who presented with life-threatening hypervitaminosis D and hypercalcaemia resulting from self-medicated doses of vitamin D supplements. This case, alongside other global case reports, highlights the potential dangers of unlicensed vitamin D replacement. We discuss the evidence for vitamin D replacement and remind readers of the current guidance on daily intake and supplementation...
August 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
Vikte Lionikaite, Anna Westerlund, H Herschel Conaway, Petra Henning, Ulf H Lerner
Increased intake of vitamin A (retinoids) is associated with decreased bone mass and increased fracture risk in humans. Mechanistic studies in rodents have shown that hypervitaminosis A results in decreased bone mass caused by an increase in periosteal osteoclasts while simultaneously decreasing endocortic osteoclasts. In vivo and ex vivo bone organ cultures have demonstrated that excess retinoids increase osteoclast formation due to increased receptor activator of nuclear factor kappa B-ligand (RANKL) expression...
July 30, 2018: Journal of Leukocyte Biology
Celia Rodd, AbdulRazaq Sokoro, Lisa M Lix, Laurel Thorlacius, Michael Moffatt, Jim Slater, Eric Bohm
INTRODUCTION: Laboratories have noted marked increases in the analysis of 25-hydroxy vitamin D (25(OH)D) in recent decades. Our objectives were to describe the annual number of 25(OH)D tests, examine the characteristics of those tested and those ordering them, and determine the proportion of potentially unnecessary tests in Manitoba. METHODS: Manitoba residents who were tested between 2006/7 and 2012/13 had their data anonymously linked to Manitoba Centre for Health Policy comprehensive administrative datasets...
September 2018: Clinical Biochemistry
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