A 30-year-old man consumed large amounts of vitamin supplements daily for several months. He now reports headache, drowsiness, and bone pain. Examination shows papilledema and hepatomegaly. Serum calcium is normal. The most likely diagnosis is:

• A Pyridoxine toxicity
• B Hypervitaminosis D
• C Hypervitaminosis E
• D Hypervitaminosis A ✓

Explanation

Chronic vitamin D excess produces raised intracranial pressure (pseudotumor cerebri), headache, drowsiness, bone pain from periosteal resorption, alopecia, and hepatomegaly due to stellate cell activation and fibrosis. The key discriminator here is the normal serum calcium: hypervitaminosis A causes hypercalcemia with its own constellation of symptoms, so it does not fit. Pyridoxine megadose toxicity causes sensory peripheral neuropathy rather than intracranial hypertension.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.