{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T23:30:21Z","timestamp":1783380621602,"version":"3.54.6"},"reference-count":20,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2006,8,1]]},"abstract":"<jats:p>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 200000 to 300000 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.<\/jats:p>","DOI":"10.1542\/peds.2006-0167","type":"journal-article","created":{"date-parts":[[2006,8,2]],"date-time":"2006-08-02T17:07:56Z","timestamp":1154538476000},"page":"820-824","source":"Crossref","is-referenced-by-count":45,"title":["Risk of Vitamin A Toxicity From Candy-Like Chewable Vitamin Supplements for Children"],"prefix":"10.1542","volume":"118","author":[{"given":"Hugh Simon","family":"Lam","sequence":"first","affiliation":[{"name":"Departments of Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chung Mo","family":"Chow","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wing Tat","family":"Poon","sequence":"additional","affiliation":[{"name":"Toxicology Reference Laboratory, Princess Margaret Hospital, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi Kong","family":"Lai","sequence":"additional","affiliation":[{"name":"Toxicology Reference Laboratory, Princess Margaret Hospital, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kwan Chee Allen","family":"Chan","sequence":"additional","affiliation":[{"name":"Chemical Pathology, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wai Lan","family":"Yeung","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joannie","family":"Hui","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert Yan Wo","family":"Chan","sequence":"additional","affiliation":[{"name":"Toxicology Reference Laboratory, Princess Margaret Hospital, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pak Cheung","family":"Ng","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2006,8,1]]},"reference":[{"key":"2021120822410999800_R1","unstructured":"Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press; 2001"},{"key":"2021120822410999800_R2","doi-asserted-by":"crossref","unstructured":"Fishman RA. Polar bear liver, vitamin A, aquaporins, and pseudotumor cerebri. Ann Neurol.\u20082002;52:531\u2013533","DOI":"10.1002\/ana.10389"},{"key":"2021120822410999800_R3","doi-asserted-by":"crossref","unstructured":"Allen LH, Haskell M. Estimating the potential for vitamin A toxicity in women and young children. J Nutr.\u20082002;132(9 suppl):2907S\u20132919S","DOI":"10.1093\/jn\/132.9.2907S"},{"key":"2021120822410999800_R4","doi-asserted-by":"crossref","unstructured":"Kowalski TE, Falestiny M, Furth E, Malet PF. Vitamin A hepatotoxicity: a cautionary note regarding 25,000 IU supplements. Am J Med.\u20081994;97:523\u2013528","DOI":"10.1016\/0002-9343(94)90347-6"},{"key":"2021120822410999800_R5","unstructured":"Bush ME, Dahms BB. Fatal hypervitaminosis A in a neonate. Arch Pathol Lab Med.\u20081984;108:838\u2013842"},{"key":"2021120822410999800_R6","doi-asserted-by":"crossref","unstructured":"Ross DA. Recommendations for vitamin A supplementation. J Nutr.\u20082002;132(9 suppl):2902S\u20132906S","DOI":"10.1093\/jn\/132.9.2902S"},{"key":"2021120822410999800_R7","doi-asserted-by":"crossref","unstructured":"Myhre AM, Carlsen MH, Bohn SK, Wold HL, Laake P, Blomhoff R. Water-miscible, emulsified, and solid forms of retinol supplements are more toxic than oil-based preparations. Am J Clin Nutr.\u20082003;78:1152\u20131159","DOI":"10.1093\/ajcn\/78.6.1152"},{"key":"2021120822410999800_R8","doi-asserted-by":"crossref","unstructured":"Hartmann S, Froescheis O, Ringenbach F, et al. Determination of retinol and retinyl esters in human plasma by high-performance liquid chromatography with automated column switching and ultraviolet detection. J Chromatogr B Biomed Sci Appl.\u20082001;751:265\u2013275","DOI":"10.1016\/S0378-4347(00)00481-3"},{"key":"2021120822410999800_R9","doi-asserted-by":"crossref","unstructured":"Lockitch G, Halstead AC, Wadsworth L, Quigley G, Reston L, Jacobson B. Age- and sex-specific pediatric reference intervals and correlations for zinc, copper, selenium, iron, vitamins A and E, and related proteins. Clin Chem.\u20081988;34:1625\u20131628","DOI":"10.1093\/clinchem\/34.8.1625"},{"key":"2021120822410999800_R10","doi-asserted-by":"crossref","unstructured":"Ballew C, Bowman BA, Russell RM, Sowell AL, Gillespie C; National Health and Nutrition Examination Survey (NHANES III). Serum retinyl esters are not associated with biochemical markers of liver dysfunction in adult participants in the third National Health and Nutrition Examination Survey (NHANES III), 1988\u20131994. Am J Clin Nutr.\u20082001;73:934\u2013940","DOI":"10.1093\/ajcn\/73.5.934"},{"key":"2021120822410999800_R11","doi-asserted-by":"crossref","unstructured":"de Francisco A, Chakraborty J, Chowdhury HR, et al. Acute toxicity of vitamin A given with vaccines in infancy. Lancet.\u20081993;342:526\u2013527","DOI":"10.1016\/0140-6736(93)91648-6"},{"key":"2021120822410999800_R12","doi-asserted-by":"crossref","unstructured":"Florentino RF, Tanchoco CC, Ramos AC, et al. Tolerance of preschoolers to two dosage strengths of vitamin A preparation. Am J Clin Nutr.\u20081990;52:694\u2013700","DOI":"10.1093\/ajcn\/52.4.694"},{"key":"2021120822410999800_R13","unstructured":"Macapinlac MP, Olson JA. A lethal hypervitaminosis A syndrome in young monkeys (Macacus fascicularis) following a single intramuscular dose of a water-miscible preparation containing vitamins A, D2 and E. Int J Vitam Nutr Res.\u20081981;51:331\u2013341"},{"key":"2021120822410999800_R14","doi-asserted-by":"crossref","unstructured":"Blomhoff R, Green MH, Green JB, Berg T, Norum KR. Vitamin A metabolism: new perspectives on absorption, transport, and storage. Physiol Rev.\u20081991;71:951\u2013990","DOI":"10.1152\/physrev.1991.71.4.951"},{"key":"2021120822410999800_R15","doi-asserted-by":"crossref","unstructured":"Reinersdorff DV, Bush E, Liberato DJ. Plasma kinetics of vitamin A in humans after a single oral dose of [8,9,19\u201313C]retinyl palmitate. J Lipid Res.\u20081996;37:1875\u20131885","DOI":"10.1016\/S0022-2275(20)37552-0"},{"key":"2021120822410999800_R16","doi-asserted-by":"crossref","unstructured":"Tang G, Qin J, Dolnikowski GG, Russell RM. Short-term (intestinal) and long-term (postintestinal) conversion of beta-carotene to retinol in adults as assessed by a stable-isotope reference method. Am J Clin Nutr.\u20082003;78:259\u2013266","DOI":"10.1093\/ajcn\/78.2.259"},{"key":"2021120822410999800_R17","doi-asserted-by":"crossref","unstructured":"Zeghoud F, Ben-Mekhbi H, Djeghri N, Garabedian M. Vitamin D prophylaxis during infancy: comparison of the long-term effects of three intermittent doses (15, 5, or 2.5 mg) on 25-hydroxyvitamin D concentrations. Am J Clin Nutr.\u20081994;60:393\u2013396","DOI":"10.1093\/ajcn\/60.3.393"},{"key":"2021120822410999800_R18","doi-asserted-by":"crossref","unstructured":"Armas LA, Hollis BW, Heaney RP. Vitamin D2 is much less effective than vitamin D3 in humans. J Clin Endocrinol Metab.\u20082004;89:5387\u20135391","DOI":"10.1210\/jc.2004-0360"},{"key":"2021120822410999800_R19","unstructured":"Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Calcium, Magnesium, Phosphorus, Vitamin D, and Fluoride. Washington, DC: National Academy Press; 1997"},{"key":"2021120822410999800_R20","doi-asserted-by":"crossref","unstructured":"Hawton K, Simkin S, Deeks J, et al. UK legislation on analgesic packs: before and after study of long term effect on poisonings [published correction appears in BMJ. 2004;329:1159]. BMJ.\u20082004;329:1076","DOI":"10.1136\/bmj.38253.572581.7C"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/118\/2\/820\/1074295\/zpe00806000820.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/118\/2\/820\/1074295\/zpe00806000820.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,9]],"date-time":"2021-12-09T02:28:44Z","timestamp":1639016924000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/118\/2\/820\/69014\/Risk-of-Vitamin-A-Toxicity-From-Candy-Like"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,8,1]]},"references-count":20,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2006,8,1]]},"published-print":{"date-parts":[[2006,8,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2006-0167","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,8,1]]}}}