[Cirrhosis of the liver and esophageal bleeding after chronic vitamin A intoxication (author's transl)].
A female patient with congenital ichthyosis took vitamin A in an uncontrolled manner throughout 3 years totalling 60 Mill. IU. This lead to cirrhosis of the liver confirmed histologically after biopsy; vitamin A could be demonstrated in tissue of liver and spleen by fluorescence microscopy. Bleeding from esophageal varices could not be stopped by conventional means, but only by sclerosing the esophageal mucosa in the areas affected. A relapse of bleeding from varices of the fornix was stopped by disconnection according to Hassab-Paquet. The patient died from hepatic failure in advanced hepatic cirrhosis. A long time treatment with high doses of vitamin A seems to be a doubtful therapeutic procedure, especially in view of the fact, that side effects of this therapy cannot be monitored by laboratory measurements; when a disturbed liver function becomes evident, irreversible damage, e.g. cirrhosis or fibrosis and portal hypertension, is already present.