Abstract Details

Title Hypervitaminosis E and a-tocopherol levels in Intracranial Hemorrhagic Stroke

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P5 - Poster Session 5 (5:30 PM-6:30 PM)

Poster/Presentation
Number 3-035

Objective To consider the possibility of hypervitaminosis E in association with acute intracerebral hemorrhage (ICH), based on elevated serum levels of α-tocopherol.

Background NA

Design/Methods We describe the clinical presentation and course of three previously healthy individuals who each developed acute ICH and were discovered independently to be consuming copious amounts of vitamin E supplementation.

Results

Patient A and B both had thalamic (subcortical) intraparenchymal hemorrhages while patient C had an intraventricular hemorrhage; the serum α-tocopherol levels in all three were elevated at 30.8, 46.7 and 23.3 mg/L, respectively (normal range 5.7 - 19.9 mg/L). No definitive alternate etiologies to their ICH was found despite a thorough workup.

Conclusions In patients with ICH without a clear-cut etiology, clinicians should avoid mislabeling the ICH as cryptogenic and consider the diagnosis of hypervitaminosis E. This can be accomplished by meticulously reviewing the patient’s pharmacologic history and asking about the use of over-the-counter supplements, such as vitamin E. Checking serum α-tocopherol levels in the acute/subacute phase may help confirm the history. The antiplatelet effect of vitamin E may considerably increase the risk of ICH, which may be underestimated, underreported, and heretofore unexplored in any clinically applicable way.

Authors/Disclosures
Nicole K. Le (University of South Florida) PRESENTER	No disclosure on file
	No disclosure on file
Tigran Kesayan, MD (VUMC Pain Medicine and Neurology)	Dr. Kesayan has nothing to disclose.
David Z. Rose, MD (USF)	Dr. Rose has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Boston Scientific. Dr. Rose has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Chiesi USA. Dr. Rose has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Medtronic. Dr. Rose has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Boehringer Ingelheim . Dr. Rose has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for CSL-Behring .

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