Prolonged Serum Alanine Aminotransferase Elevation Associated with Isotretinoin Administration
Isotretinoin is a highly effective oral retinoid derivative for severe forms of acne. Despite its high margin of safety, isotretinoin carries a risk of teratogenicity and mild to massive elevations of serum cholesterol and triglyceride levels, as well as infrequent transaminitis. Liver dysfunction i...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Case Reports in Hepatology |
| Online Access: | http://dx.doi.org/10.1155/2019/9270827 |
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| author | Roya S. Nazarian Elizabeth Zheng Caroline Halverstam Steven R. Cohen Allan W. Wolkoff |
| author_facet | Roya S. Nazarian Elizabeth Zheng Caroline Halverstam Steven R. Cohen Allan W. Wolkoff |
| author_sort | Roya S. Nazarian |
| collection | DOAJ |
| description | Isotretinoin is a highly effective oral retinoid derivative for severe forms of acne. Despite its high margin of safety, isotretinoin carries a risk of teratogenicity and mild to massive elevations of serum cholesterol and triglyceride levels, as well as infrequent transaminitis. Liver dysfunction induced by isotretinoin is rare but it poses a management dilemma. We describe a 16-year-old male in whom alanine aminotransferase (ALT) rose from a baseline of 13 to 288 U/L after 20 weeks of treatment with 1.0-1.4 mg/kg of oral isotretinoin daily. Though the patient remained asymptomatic, ALT levels did not return to normal limits for approximately 8 months after discontinuation of therapy, an observation that has not been documented in the literature. When oral isotretinoin was readministered for intractable facial acne 3 years later, liver enzymes remained normal throughout the course of therapy. Although the pathogenesis and prognosis of retinoid-induced hepatotoxicity are unknown, this case illustrates that isotretinoin may be safely readministered after normalization of liver function tests. |
| format | Article |
| id | doaj-art-b8c0fefb19c04faaaa06f9404fa53e56 |
| institution | Kabale University |
| issn | 2090-6587 2090-6595 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Hepatology |
| spelling | doaj-art-b8c0fefb19c04faaaa06f9404fa53e562025-02-03T01:01:33ZengWileyCase Reports in Hepatology2090-65872090-65952019-01-01201910.1155/2019/92708279270827Prolonged Serum Alanine Aminotransferase Elevation Associated with Isotretinoin AdministrationRoya S. Nazarian0Elizabeth Zheng1Caroline Halverstam2Steven R. Cohen3Allan W. Wolkoff4Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place New York, NY 10029, USADivision of Digestive and Liver Disease, Columbia University, 622 W 168th St, New York, NY 10032, USADivision of Dermatology, Albert Einstein College of Medicine and Montefiore Medical Center, 3411 Wayne Avenue, Bronx, NY 10467, USADivision of Dermatology, Albert Einstein College of Medicine and Montefiore Medical Center, 3411 Wayne Avenue, Bronx, NY 10467, USAMarion Bessin Liver Research Center, Division of Hepatology, Albert Einstein College of Medicine and Montefiore Medical Center, 1300 Morris Park Avenue, Bronx, NY 10461, USAIsotretinoin is a highly effective oral retinoid derivative for severe forms of acne. Despite its high margin of safety, isotretinoin carries a risk of teratogenicity and mild to massive elevations of serum cholesterol and triglyceride levels, as well as infrequent transaminitis. Liver dysfunction induced by isotretinoin is rare but it poses a management dilemma. We describe a 16-year-old male in whom alanine aminotransferase (ALT) rose from a baseline of 13 to 288 U/L after 20 weeks of treatment with 1.0-1.4 mg/kg of oral isotretinoin daily. Though the patient remained asymptomatic, ALT levels did not return to normal limits for approximately 8 months after discontinuation of therapy, an observation that has not been documented in the literature. When oral isotretinoin was readministered for intractable facial acne 3 years later, liver enzymes remained normal throughout the course of therapy. Although the pathogenesis and prognosis of retinoid-induced hepatotoxicity are unknown, this case illustrates that isotretinoin may be safely readministered after normalization of liver function tests.http://dx.doi.org/10.1155/2019/9270827 |
| spellingShingle | Roya S. Nazarian Elizabeth Zheng Caroline Halverstam Steven R. Cohen Allan W. Wolkoff Prolonged Serum Alanine Aminotransferase Elevation Associated with Isotretinoin Administration Case Reports in Hepatology |
| title | Prolonged Serum Alanine Aminotransferase Elevation Associated with Isotretinoin Administration |
| title_full | Prolonged Serum Alanine Aminotransferase Elevation Associated with Isotretinoin Administration |
| title_fullStr | Prolonged Serum Alanine Aminotransferase Elevation Associated with Isotretinoin Administration |
| title_full_unstemmed | Prolonged Serum Alanine Aminotransferase Elevation Associated with Isotretinoin Administration |
| title_short | Prolonged Serum Alanine Aminotransferase Elevation Associated with Isotretinoin Administration |
| title_sort | prolonged serum alanine aminotransferase elevation associated with isotretinoin administration |
| url | http://dx.doi.org/10.1155/2019/9270827 |
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