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World J Hepatol. Aug 27, 2025; 17(8): 107738
Published online Aug 27, 2025. doi: 10.4254/wjh.v17.i8.107738
Vitamin A toxicity and hepatic pathology: A comprehensive review
María L Pestalardo, Cecilia S Bevilacqua, Marcelo Fabián Amante
María L Pestalardo, Marcelo Fabián Amante, División Patología, Hospital General de Agudos Cosme Argerich, Buenos Aires C1155AHA, Argentina
Cecilia S Bevilacqua, División Patología, Nuevo Hospital Iturraspe, Santa Fe S2800XAH, Argentina
Co-first authors: María L Pestalardo and Cecilia S Bevilacqua.
Author contributions: Pestalardo ML and Bevilaqua CS have made crucial and indispensable contributions towards the completion of the project and thus qualified as the co-first authors of the paper; Pestalardo ML and Amante MF made equal contributions to the conceptualization and design of the study, creation of the artwork, supervision, and making critical revisions to the various versions of the manuscript, underlying their role; Bevilaqua CS conducted the literature review, performed the analysis and interpretation of data, and drafted the original manuscript; Bevilacqua CS and Amante MF contributed equally in the overall completion of this work; all authors prepared the draft and approved the submitted version.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Marcelo Fabián Amante, MD, Chief Physician, Professor, División Patología, Hospital General de Agudos Cosme Argerich, Pi y Margall 480, Buenos Aires C1155AHA, Argentina. marcelofabianamante@gmail.com
Received: April 9, 2025
Revised: May 21, 2025
Accepted: July 23, 2025
Published online: August 27, 2025
Processing time: 152 Days and 9.9 Hours
Core Tip

Core Tip: Vitamin A toxicity (hypervitaminosis A) causes serious liver damage, progressing from steatosis to fibrosis and cirrhosis. The liver’s storage capacity is overwhelmed, leading to retinoid accumulation, oxidative stress, and inflammation. Key mechanisms include reactive oxygen species generation, apoptosis, and dysregulated pathways (tumor growth factor-beta, nuclear factor-kappa B), which drive stellate cell activation and fibrosis. Clinically, chronic toxicity manifests as hepatomegaly, portal hypertension, and potential liver failure. Management involves limiting vitamin A intake and exploring antioxidants (e.g., N-acetylcysteine) or anti-fibrotic therapies. Future research should focus on biomarkers, personalized risk assessment, and safer dietary guidelines. Public awareness and therapeutic advancements are crucial to prevent liver disease.