A 5-year-old child whose mother gave large doses of cod liver oil daily for over a year presents with bone pain, difficulty walking, alopecia, dry rough skin, hepatomegaly, and X-rays showing cortical hyperostosis of the ulna and metatarsals. What is the diagnosis?

• A Vitamin D intoxication
• B Chronic hypervitaminosis A ✓
• C Infantile cortical hyperostosis (Caffey disease)
• D Fluorosis

Explanation

Chronic hypervitaminosis B from prolonged excessive intake produces bone pain, alopecia, dry pruritic skin, hepatomegaly from storage, and radiological cortical hyperostosis of tubular bones. Cod liver oil is a concentrated source of preformed retinol. Vitamin D intoxication causes hypercalcemia, hypercalciuria, and nephrocalcinosis rather than hyperostosis. Caffey disease presents in infancy with mandibular swelling and fever, not with alopecia and hepatomegaly.

Reference: Nelson Textbook of Pediatrics, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.