Hypervitaminosis A-induced premature closure of epiphyses (physeal obliteration) in humans and calves (hyena disease): a historical review of the human and veterinary literature
- 328 Downloads
Vitamin A toxicity in the infant, which now occurs rarely from dietary overdosage, was recognized in the 1940s as painful periostitis with rare progression to premature closure of the lower limb epiphyses. Decades later, most cases of vitamin A-induced premature epiphyseal closure (physeal obliteration) occur in pediatric dermatologic patients given vitamin A analogues. This phenomenon resembles a strange disease discovered in more recent years in calves with closed epiphyses of the hind limbs, known as hyena disease. This was a mystery until proved to be caused by vitamin A toxicity from enriched grain that causes the calves to have short hind limbs that resemble those of a hyena and gait disturbance. This historical review links the human and veterinary literature in terms of vitamin A-induced epiphyseal closure using a case report format of a 16-month-old human infant with closed knee epiphyses and gait disturbance that is reminiscent of hyena disease seen in calves.
KeywordsVitamin A Epiphyses Overdose Gait Children
- 3.Silverman FN (ed) (1985) Caffey’s pediatric x-ray diagnosis, 8th edn. Year Book Medical Publishers, Chicago, pp 679–683Google Scholar
- 7.MacKay RJ, Woodard JC, Donovan GA (1992) Focal premature physeal closure (hyena disease) in calves. J Am Vet Med Assoc 58:311–316Google Scholar
- 8.Caffey J (1970) Traumatic cupping of the metaphyses of growing bones. AJR 108:451–460Google Scholar
- 9.Wolbach SB (1947) Vitamin A deficiency and excess in relation to skeletal growth. J Bone Joint Surg 29:171–192Google Scholar