Risk of vitamin A toxicity from candy-like chewable vitamin supplements for children.
Numerous vitamin supplements are available over-the-counter to the general public. Some such supplements are available as candy-like chewable preparations to encourage consumption by children. We report 3 cases of overdose of such preparations. Each patient had taken an estimated 200,000 to 300,000 IU of vitamin A. Their circulating vitamin A (retinol and retinyl palmitate) concentrations were monitored over a 6-month period. There were no clinical or biochemical complications noted. However, there were marked increases in both retinol and retinyl palmitate concentrations above age-related reference ranges. In particular, it took 1 to 3 weeks for the serum retinol concentrations to peak and many months for them to normalize. Parents should be warned about the dangers of excessive vitamin consumption. Clinicians should be aware of the late peak in serum retinol concentrations, which may lead to late complications of vitamin A overdose.
Lam
Hugh Simon
HS
Department of Pediatrics, Prince of Wales Hospital, Chinese University of Hong Kong, Sha Tin, New Territories, Hong Kong. hshslam@cuhk.edu.hk
Chow
Chung Mo
CM
Poon
Wing Tat
WT
Lai
Chi Kong
CK
Chan
Kwan Chee Allen
KC
Yeung
Wai Lan
WL
Hui
Joannie
J
Chan
Albert Yan Wo
AY
Ng
Pak Cheung
PC
D001711:Biotransformation; D002182:Candy; D002675:Child, Preschool; D019587:Dietary Supplements / Q000009:adverse effects*; D004224:Diterpenes; D062787:Drug Overdose; D004872:Ergocalciferols / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics; D005500:Follow-Up Studies; D006723:Hong Kong; D006801:Humans; D006986:Hypervitaminosis A / Q000209:etiology*; D008297:Male; D000084562:Retinyl Esters; D012306:Risk; D013607:Tablets; D014801:Vitamin A / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000097:blood / Q000493:pharmacokinetics
D004224:Diterpenes; D004872:Ergocalciferols; D000084562:Retinyl Esters; D013607:Tablets; D014801:Vitamin A; C014794:retinol palmitate