Vitamin A-induced cholestatic hepatitis: a case report

P. Becker, B. Maurer, P. Schirmacher, R. Waldherr, A. Parlesak, C. Bode, H. K. Seitz

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

We report a case of intrahepatic cholestasis due to chronic vitamin A supplementation. A 70-year-old woman was admitted to the hospital for jaundice and reduced nutritional and general status with a 2-month history of increasing cholestasis. Some years previously she had suffered from breast and ovarian cancer with subsequent surgery and chemotherapy. Chemotherapy was terminated one month before elevated serum transaminase activities and cholestatic serum markers were noted. Following the chemotherapy, supportive care included weekly vitamin A injections (100,000 IU per injection). Liver biopsy showed an acute toxic liver injury with focal parenchymal necrosis, sinusoidal lesions, inflammatory infiltrate (round cells, macrophages), and activation and proliferation of stellate cells. The hepatic vitamin A concentration was found to be significantly elevated. There were no signs of intrahepatic metastasis or liver cirrhosis. Treatment with ursodeoxycholic acid rapidly improved the cholestasis and led to a total recovery after three weeks.
Original languageEnglish
JournalZeitschrift für Gastroenterologie
Volume45
Issue number10
Pages (from-to)1063-1066
ISSN0044-2771
DOIs
Publication statusPublished - 2007
Externally publishedYes

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