Carotenemia Workup

Updated: Mar 30, 2020
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Dirk M Elston, MD  more...
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Workup

Approach Considerations

Laboratory studies

Laboratory studies are not generally indicated in the evaluation of diet-induced carotenemia. If studies are made, carotenemia can be verified by a high serum beta-carotene level, normal liver function test results, and a normal or slightly elevated vitamin A level. (The serum beta-carotene level can be increased 3-4 times the normal value and still be associated with a normal or only slightly elevated vitamin A level.) Accumulation of beta-carotene in the skin is delayed by up to 2 weeks, in contrast to the serum.

Elevated serum carotene levels range between 250-500 µg/dL. Multiple authors have reported wide variations in reference range values of serum carotene, making the interpretation of such values difficult.

Measuring carotene levels in skin may be facilitated by use of Resonance Raman spectroscopy and reflection spectroscopy, both noninvasive optical quantitative methods for the measurement of carotenoid antioxidant levels in human skin in vivo. Skin carotenoid status may be a good way to predict plasma carotenoid status. [21, 22]

β-Carotenemia was misdiagnosed as jaundice using the Bilirubin Oxidase Method. [23]

Histologic findings

A skin biopsy specimen may show autofluorescence in the superficial horny layer and a pemphiguslike pattern of intracellular autofluorescence.