Pediatric Radiology

, Volume 37, Issue 12, pp 1264–1267

Hypervitaminosis A-induced premature closure of epiphyses (physeal obliteration) in humans and calves (hyena disease): a historical review of the human and veterinary literature

  • Alexis B. Rothenberg
  • Walter E. Berdon
  • J. Carroll Woodard
  • Robert A. Cowles
Historical Perspective

Abstract

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.

Keywords

Vitamin A Epiphyses Overdose Gait Children 

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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Alexis B. Rothenberg
    • 1
  • Walter E. Berdon
    • 1
    • 4
  • J. Carroll Woodard
    • 2
  • Robert A. Cowles
    • 3
  1. 1.Division of Pediatric Radiology, Department of RadiologyColumbia University College of Physicians and Surgeons, Morgan Stanley Children’s Hospital of New York-PresbyterianNew YorkUSA
  2. 2.College of Veterinary MedicineUniversity of FloridaGainesvilleUSA
  3. 3.Division of Pediatric Surgery, Department of SurgeryColumbia University College of Physicians and Surgeons, Morgan Stanley Children’s Hospital of New York-PresbyterianNew YorkUSA
  4. 4.Division of Pediatric RadiologyNew YorkUSA

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