medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2024-341medsovet-8517Research ArticleОФТАЛЬМОЛОГИЯOPHTHALMOLOGYКлинический случай манифестации токсического кератита на фоне интоксикации витамином АClinical case of manifestation of toxic keratitis with vitamin A intoxicationhttps://orcid.org/0000-0002-2931-0796НарбутМ. Н.NarbutM. N.

Нарбут Мария Николаевна - младший научный сотрудник отдела патологии оптических сред глаза.

119021, Москва, ул. Россолимо, д. 11а, б

Maria N. Narbut - Senior Researcher, Department of Pathology of the Optical Media, Krasnov Research Institute of Eye Diseases.

11a, b, Rossolimo St., Moscow, 119021

doctornarbut@gmail.comhttps://orcid.org/0000-0001-5692-1800СурнинаЗ. В.SurninaZ. V.

Сурнина Зоя Васильевна - д.м.н., старший научный сотрудник отдела патологии оптических сред глаза.

119021, Москва, ул. Россолимо, д. 11а, б

Zoya V. Surnina - Dr. Sci. (Med.), Senior Researcher, Department of Pathology of the Optical Media, Krasnov Research Institute of Eye Diseases.

11a, b, Rossolimo St., Moscow, 119021

medzoe@yandex.ruhttps://orcid.org/0000-0001-6006-0142МожаровскаяМ. В.MozharovskayaM. V.

Можаровская Марьяна Вячеславовна - к.м.н., ассистент кафедры глазных болезней.

119991, Москва, ул. Большая Пироговская, д. 6, стр. 1

Maryana V. Mozharovskaya - Cand. Sci. (Med.), Sechenov First Moscow State Medical University (Sechenov University).

6, Bldg. 1, Bolshaya Pirogovskaya St., Moscow, 119991

cdelmar@mail.ruНаучно-исследовательский институт глазных болезней имени М.М. КрасноваРоссияKrasnov Research Institute of Eye DiseasesRussian FederationПервый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)РоссияSechenov First Moscow State Medical University (Sechenov University)Russian Federation202403092024013197202Copyright © Нарбут М.Н., Сурнина З.В., Можаровская М.В., 20242024Нарбут М.Н., Сурнина З.В., Можаровская М.В.Narbut M.N., Surnina Z.V., Mozharovskaya M.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/8517

Витамины являются группой органических соединений, необходимых для жизнеобеспечения и функционирования организма. Они участвуют в гуморальной регуляции, выполняют ферментативную и каталитическую функции, их недостаток в организме может приводить к развитию серьезных жизнеугрожающих заболеваний. Однако переизбыток витаминов также небезопасен для человека. Так, в частности, гипервитаминоз А может повлечь развитие токсического кератита. Гипервитаминоз А может возникнуть при употреблении больших доз ретиноидов, которые хорошо усваиваются и медленно выводятся; к гипервитаминозу может привести как одномоментное употребление большого количества витамина А, так и длительный прием сравнительно умеренных доз. При хронической передозировке указанным витамином могут наблюдаться кожный зуд, дерматит, нарушение пигментации кожи, сухость слизистых оболочек рта и конъюнктивы глаза, выпадение волос, повышенная ломкость ногтей, носовые кровотечения, разрушение костной и хрящевой тканей, токсический гепатит, а в тяжелых случаях - кома. Для лечения ряда дерматозов (акне) врачи нередко используют витамин А, при этом кумулятивные дозы препаратов могут быть значительно выше допустимых. В данной статье представлен редкий клинический случай манифестации токсического кератита на фоне приема витамина А в дозировках, превышающих терапевтические. Пациентке удалось восстановить целостность роговицы и вылечить кератит на фоне длительных местных инстилляций капель, в т. ч. таурина.

Vitamins are a group of organic compounds that are required to support life and perform biological functions of a living organism. They participate in humoral regulation, perform enzymatic and catalytic functions, their deficiency can result in the development of serious life-threatening diseases. However, taking too much of some vitamins can also be dangerous for a human. In particular, hypervitaminosis A can lead to the development of toxic keratitis. Hypervitaminosis A can arise after consumption of large doses of retinoids, which are efficiently absorbed and slowly excreted; hypervitaminosis can result from both one-time use of large amounts of vitamin A and long-term use of relatively moderate doses. Chronic overdose of this vitamin may cause skin itching, dermatitis, skin pigmentation disorders, dry oral and conjunctiva mucous membranes, hair loss, increased brittleness of nails, nosebleeds, destruction of bone and cartilage tissue, toxic hepatitis, and coma in severe cases. Doctors often use vitamin A to treat some dermatoses (acne), while the cumulative doses of drugs can be significantly higher than the allowed ones. This article presents a rare clinical case of manifestation of toxic keratitis in a patient receiving vitamin A at doses exceeding therapeutic ones. The patient managed to restore the integrity of the cornea and get rid of keratitis while receiving long-term local instillations of drops, including taurine.

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The authors declare that there are no conflicts of interest present.