TY - JOUR T1 - Vitamin A toxicity presenting as bone pain JF - Archives of Disease in Childhood JO - Arch Dis Child SP - 556 LP - 558 DO - 10.1136/archdischild-2016-310631 VL - 102 IS - 6 AU - Revanth Baineni AU - Reena Gulati AU - CG Kumar Delhi Y1 - 2017/06/01 UR - http://adc.bmj.com/content/102/6/556.abstract N2 - A 4-year-old boy presented with severe bone pains, refusal to walk, diffuse bony swelling of forelimbs, skin changes and abdominal pain, with symptoms evolving over 6 weeks. Blood screening tests were normal except for raised aspartate aminotransferase (AST). Radiographs revealed thickened periosteum, widening of the diaphyses of long bones and lifted periosteum in mid-shaft of ulnae and right femur. Skeletal scintigraphy showed a high uptake of radionuclide at clinically affected and unaffected sites, suggestive of multifocal osteoblastic skeletal lesions. After repeated enquiries, his parents admitted to giving him massive doses of preformed vitamin A for over 3 months as ‘health tablets’. Surprisingly, he did not have overt liver disease typically found with much smaller doses, although the dermal changes and musculoskeletal pathology were florid. He made a full clinical recovery within 2 months of cessation of vitamin A. ER -