From the Guidelines
Vitamin A toxicity in pediatric patients can occur at doses exceeding 150,000 ug acutely or 30,000 ug/day chronically, as stated in the study by 1.
Key Points to Consider
- The study 1 highlights the risks of vitamin A toxicity, particularly in patients with liver and renal disorders.
- According to the guidelines 1, recommended doses for parenteral supply of vitamin A for preterm infants, infants, and children are provided, but these doses should not be exceeded to avoid toxicity.
- The narrow window between deficiency and toxicity of vitamin A, as mentioned in 1, necessitates careful monitoring and dosing to prevent adverse effects.
- Signs of acute toxicity include increased intracranial pressure, nausea, vomiting, vertigo, blurred vision, and muscular incoordination, while chronic toxicity presents with bone abnormalities, dermatitis, alopecia, ataxia, muscle pain, and other symptoms, as outlined in 1.
Recommendations for Safe Vitamin A Administration
- Follow recommended dosages for parenteral vitamin A supply, as outlined in 1, to minimize the risk of toxicity.
- Monitor patients closely for signs of toxicity, particularly those with liver and renal disorders.
- Be aware of the potential for acute and chronic toxicity, and adjust dosing accordingly to prevent adverse effects.
- Keep supplements out of children's reach and educate caregivers on the importance of following recommended dosages to prevent accidental overdose and toxicity.
From the Research
Vitamin A Toxicity in Pediatrics
- The toxic dose of vitamin A in pediatrics is not explicitly stated in the provided studies 2, 3, 4.
- However, it is mentioned that high doses of vitamin A can cause adverse health consequences, including death 3, 4.
- The recommended dietary intake of vitamin A increases from 250μg RE/day between 7 and 36 months of age to 750μg RE/day between 15 and 17 years of age 2.
- Intakes above the upper limit (600μg/day) can occur in some non-breastfed infants, and excessive intake can lead to hypervitaminosis A 2.
- Carotenoids, such as β-carotene, do not cause hypervitaminosis A, as they are converted to retinol in the body and do not accumulate to toxic levels 2.
Vitamin A Supplementation
- Vitamin A supplementation is recommended for children aged 6 to 59 months in populations at risk of vitamin A deficiency (VAD) 3, 4.
- Supplementation has been shown to reduce morbidity and mortality in children, with a 12% observed reduction in the risk of all-cause mortality 3, 4.
- However, high doses of vitamin A can cause side effects, such as vomiting, within the first 48 hours of supplementation 3, 4.