• Yosuke Homma, Norio Otani, and Shinichi Ishimatsu.
• Department of Emergency Medicine, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu-city, Chiba, Japan.
• J Emerg Med. 2015 Jul 1;49(1):15-7.

BackgroundChronic vitamin A intoxication is well known; however, there are few reports of acute vitamin A intoxication due to the ingestion of food rich in vitamin A, particularly in adults.Case ReportWe report a case of a 27-year-old man presenting with chief complaints of flushing, headache, nausea, and joint pain. He had consumed 800 g of grilled ocean perch liver the day before and had experienced numbness shortly after. Although physical examination revealed only facial flushing, we suspected acute vitamin A intoxication due to his diet history. On day 2 after ingestion, his serum retinol levels were elevated at 1577 ng/mL, which confirmed vitamin A intoxication. He returned for follow-up on day 4 after ingestion, by which time his presenting symptoms had improved, but he had developed desquamation of his facial skin. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Emergency physicians should consider acute vitamin A intoxication in the differential diagnosis of patients with headache, flushing, desquamation, nausea, and vomiting of unknown etiology. Complete diet histories and checking vitamin A levels are essential for diagnosis. This report highlights the diagnostic difficulties associated with vitamin A intoxication and the importance of an accurate diet history.Copyright © 2015 Elsevier Inc. All rights reserved.

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