TY - JOUR

T1 - Vitamin A-induced cholestatic hepatitis

T2 - A case report

AU - Becker, P

AU - Maurer, B

AU - Schirmacher, P

AU - Waldherr, R

AU - Parlesak, Alexandr

AU - Bode, Cristiana

AU - Seitz, Helmut Karl

N1 - (Ekstern)

PY - 2007

Y1 - 2007

N2 - 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.

AB - 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.

KW - Cholestasis

KW - Hepatitis

KW - Vitamin A

U2 - 10.1055/s-2007-963342

DO - 10.1055/s-2007-963342

M3 - Journal article

C2 - 17924304

AN - SCOPUS:36048933961

VL - 45

SP - 1063

EP - 1066

JO - Zeitschrift fur Gastroenterologie

JF - Zeitschrift fur Gastroenterologie

SN - 0044-2771

IS - 10

ER -