HYPERVITAMINOSIS A 611 



Cubertier,^'^^ Palacios Mateos,"^^ Kniidson and Rothman,"^^ and a short 

 discussion in Nutrition Reviews.'' ^^'' 



In some cases the symptoms of hyper\dtaminosis A appear after the in- 

 gestion of a single excessive dose of vitamin A. Doutt""^ hsted the follow- 

 ing symptoms as typical of hypervitaminosis A in man: nausea, violent 

 headache, dizziness, and torpor. As noted earlier, the peeling of the skin 

 from a large part of the body may also be considered as a typical symp- 

 tom. '^^^'"^'^ In the case of children and infants with acute hypervita- 

 minosis A, ^•omiting and drowsiness were observed, as well as the bulging 

 of the fontanelle (acute benign hydrocephalus). ^^^^'^^^^'"^^ 



H3^pervitaminosis A symptoms were most frequently produced in chil- 

 dren by long-continued excessive doses of vitamin A preparations. Symp- 

 toms included anorexia, growth failure, irritabihty, skeletal lesions, and 

 skin symptoms such as itching fissures at the corners of the mouth and nos- 

 trils, coarsening of the hair, and a gradual development of alopecia. "°^ 

 Plasma vitamin A was largely increased, and usually the phosphatase level 

 also rose. An excess of vitamin A in the blood of children who had re- 

 ceived large doses of vitamin A was noted by Caffey.^^^^ H3T)erostoses in 

 various bony structures were also a prominent symptom. In the twenty- 

 five cases of known hj'pervitaminosis A recorded in hinnans by Nieman and 

 Klem Obbink,""^ only two concerned this condition in the adult. "^^'^^^^ 



(4) The Level of Vitamin A Intake Which Causes Toxicity 



As is the case with other drugs, the level at which toxicity may be pro- 

 duced depends upon whether single or multiple injections are given, and 

 upon the route of administration. 



a. Acute Toxicity in the Rat, It was indicated by the experiments of 



''^*S. Cubertier, Sur les accidents toxiqites causes par des fortes doses de vitamine A. 

 Etude chez Vanimal et chez Venfant. These, Paris, 1949; cited by C. Nieman and H. J. 

 Klein Obbink, Vitamins and Hormones, 12, 69-99 (1954), p. 77. 



1'" J. M. Palacios Mateos, Rev. din. espan., 43, 269-271 (1951). 



"56 A. G. Knudson, Jr., and P. E. Rothman, Am. J. Diseases Children, 85, 316-334 

 (1953). 



"" Anonymous, Nutrition Revs., 6, 261-263 (1948). 



'158 E. V. Poslavskii and A. G. Bogatkina, Klin. Med. (U.S.S.R.), 11, 49-55 (1948); 

 cited by C. Nieman and H. J. Klein Obbink, Vitamins and Hormones, 12, 69-99 (1954), 

 pp. 77, 82. 



'159 T. C. Lonie, New Zealand Med. J., 49, 680-685 (1950). 



"«• J. Marie and G. See, Semaine hdp. Paris, 27, 1744-1746 (1951). 



"«' J. M. Chiet Garcia, Acta Pediat. Espan. (Madrid), 9, No. 108, 1448-1449 (1951). 



"«2 J. CafTey, Pediatrics, 5, 672-688 (1950). 



11" M. B. Sulzberger and M. P. Lazar, /. Am. Med. Assoc, 146, 788-793 (1951). 



ii«^ J. R. Frey and M. A. Schoch, Dermatologica, 104, 80-86 (1952). 



