Acute fish liver intoxication induced blisters formation and generalized skin peeling

Abstract

Introduction: Acute fish liver intoxication, including hypervitaminosis A and hypervitaminosis D, may result from the ingestion of certain fish livers. The typical symptoms of hypervitaminosis A include nausea, headache, blurred vision, and cutaneous manifestations, such as flushing, vesicles formation, and desquamation. Hypervitaminosis D may result in hypercalcemia. We report a case of acute fish liver intoxication with systemic and cutaneous manifestations.

Case: A 63-year-old male presented to the clinic with generalized desquamation and multiple clear-fluid filled flaccid vesicles after eating approximately two fist-sized portions (about 300–400 g) of cooked seerfish (Scomberomorus spp.) liver. Laboratory examination showed a high serum level of vitamin A and D, and hypercalcemia.

Conclusions: Fish liver consumption from particular fish may result in acute hypervitaminosis A and D. In patients with skin detachment or blister formation, headache, drowsiness, and other symptoms and signs consistent with hypervitaminosis A and/or hypercalcemia, a history of fish intake should be sought, and a serum level of vitamin A and D should be measured.

Keywords:

• Acute fish liver intoxication
• hypervitaminosis A
• hypercalcemia
• vitamin D

Acknowledgments

We thank Whole-Genome Research Core Laboratory of Human Diseases and Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Keelung and Linkou, for technical and analytical support. This study was supported by grants from the Chang Gung Memorial Hospital, Linkou [CMRPG-1F0111].

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.