A Case With Bilateral Sacroiliitis and Polyneuropathy Development Due to Isotretinoin Use

Çakır, Tuğrul; Subaşı, Volkan; Bilgili, Adem; Demirdal, Ümit Seçil; Ülker, Rahime Nur

doi:10.5606/archrheumatol.2014.4515

Cited by 4 publications

(8 citation statements)

References 14 publications

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“…Isotretinoin is commonly used as a systemic and effective medication for the treatment of severe and treatment-resistant acne vulgaris and sacroiliitis can rarely occur as an adverse effect. [3][4][5][6] The reported prevalence is between 2.38% to 8.20%. 7,8 Sacroiliitis, which can be defined as the inflammation of the sacroiliac joint, is a primary manifestation of axial SpA and may be seen in many other rheumatic and nonrheumatic disorders such as familial Mediterranean fever, Behçet's disease, hyperparathyroidism, and various pyogenic sources.…”

Section: Discussionmentioning

confidence: 99%

“…9 In the literature, there are reports of cases of unilateral or bilateral sacroiliitis after isotretinoin use. [3][4][5][6][7][8]10 The mechanism of the sacroiliitis is not understood clearly. It is thought that isotretinoin shows detergentlike effects and induces changes in lysosomal membrane structures, causing degeneration in synovial cells, induces hypersensitivity reactions on these cells, and causes synovial cells to become sensitive to minor or mild traumas.…”

Section: Discussionmentioning

confidence: 99%

“…2 While arthralgia and myalgia are more common in case reports, sacroiliitis has been described as a rare side effect. [3][4][5][6] Herein, we report and describe the case of a 26-year-old female diagnosed with sacroiliitis after 8 weeks of isotretinoin treatment.…”

mentioning

confidence: 99%

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Isotretinoin Treatment-Induced Sacroiliitis

Gökbel¹,

Gözpinar²,

Dursun³

et al. 2021

Turkiye Klinikleri J Case Rep

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Isotretinoin, a vitamin A derivative, is approved by the Food and Drug Administration as a cure for severe recalcitrant acne vulgaris, and recommended for severe nodular acne and treatment resistant moderate acne. 1 Many adverse effects associated with the isotretinoin use have been reported. Among those, the most common adverse effects include mucocutaneous, musculoskeletal and ophthalmological systems. These adverse effects are temporary and reduce without sequelae following the discontinuation of the drug. 1 Adverse effects in the musculoskeletal system are bone abnormalities and rheumatologic manifestations. 2 Seronegative spondyloarthropathy (SpA) like abnormalities including hyperosteosis, extraspinal calcifications, diffuse idiopathic skeletal hyperosteosis, bilateral and unilateral sacroiliitis, enthesopathy, costochondritis, and arthralgia, arthritis, myalgia, myopathy, vasculitis, and other complications have all been reported. 2 While arthralgia and myalgia are more common in case reports, sacroiliitis has been described as a rare side effect. [3][4][5][6] Herein, we report and describe the case of a 26-year-old female diagnosed with sacroiliitis after 8 weeks of isotretinoin treatment. CASE REPORTA 26-year-old female patient had used isotretinoin 30 mg daily for her facial acne for a period of 2 months, 2 years ago. After 8 weeks of isotretinoin treatment, she experienced inflammatory pain in her lower back and right hip region. Due to this pain, the isotretinoin treatment was ceased. While the lower back pain decreased, her right hip pain was persistent. She did not report any significant trauma and she had no histories of recent genitourinary or gastrointestinal infections. Her written inform consent was provided.Regarding physical examination, the lumbar flexion of the patient was normal and the sacroiliac stress test was positive on the right side. There were no enthesopathy, peripheral arthiritis, ocular findings, cutaneous lesions. The other locomotor and neurologic system findings appeared to be normal.Laboratory analysis showed that blood chemistry and complete blood count were in a normal range, while acute phase reactants including C-reactive protein and erythrocyte sedimentation levels were elevated [10.88 mg/dL (normal range: ≤0.5 mg/dL) and 87 mm/h (normal range: 0-20 mm/h), respectively]. These levels decreased to normal

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Isotretinoin Treatment-Induced Sacroiliitis

Gökbel¹,

Gözpinar²,

Dursun³

et al. 2021

Turkiye Klinikleri J Case Rep

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“…Tüm hastalarda romatoid faktör, antinükleer antikor ve Brusella testlerinde patoloji saptanmamıştır. 4,5,[7][8][9][10][11][12][13][14] Literatürdeki hastalardan sadece ikisinde HLA-B27 pozitifliği tespit edilmiştir. 4,8 İzotretinoin tedavisine bağlı spondiloartropati ile ilişkili semptomları inceleyen tek prospektif kontrollü çalışma, Alkan ve ark.nın yaptığı çalışmadır.…”

Section: Discussionunclassified

Sacroilii2s Associated with Using Isotre2noin: Case Report

Erol¹,

Sabir²,

Şahin³

2019

J PMR Sci

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akroiliak eklemin iltihabı olan sakroiliit, ankilozan spondilitin karakteristik bir bulgusu olmakla birlikte, ayrıca; psöriyatik artropati, ailesel Akdeniz ateşi, Behçet hastalığı, hiperparatiroidizm gibi romatizmal ve nonromatizmal hastalıkların seyri sırasında da görülebilmektedir. Literatürde; Brusella enfeksiyonuna, kristallerin (gut-psödogut) indüklemesine, malign hastalıklara, izotretinoine bağlı sakroiliit hastaları da bildirilmiştir. 1 Akne tedavisinde kullanılan vitamin A türevi bir ilaç olan izotretinoin, trans retinoik asidin cis-izomeridir. Vücutta trans retinoik aside dönüşmekte ve daha sonra retinoik asit reseptörlerine ve retinoid asit reseptörlerine bağlanmaktadır. Etkisini ise akne patogenezinde rol alan sebum hipersekresyonu, intraduktal epitelyal hiperkeratinizasyon, Propionibacterium acnes proliferasyonu ve inflamasyonu azaltarak göstermektedir. 2,3 En sık yan etkileri, mukokutanöz, kas-iskelet, nörolojik ve oküler sistem üzerinedir. Kas-iskelet sistemine ait en sık yan etkileri ise artralji, miyalji ve İzotretinoin Kullanımına Bağlı Sakroiliit Gelişimi Ö ÖZ ZE ET T Sakroiliit, özellikle ankilozan spondilitin karakteristik bir bulgusu olmakla birlikte; psöriyatik artropati, ailesel Akdeniz ateşi, Behçet hastalığı, hiperparatiroidizm gibi hastalıkların seyri sırasında görülebilmektedir. Ayrıca, literatürde Brusella enfeksiyonuna, kristallerin (gut-psödogut) indüklemesine, malign hastalıklara, izotretinoine bağlı sakroiliit olguları da mevcuttur. Akne tedavisinde kullanılan vitamin A türevi bir ilaç olan izotretinoinin, kas-iskelet sistemine ait en sık yan etkiler;i artralji, miyalji olmakla birlikte daha nadir olarak sakroiliit, artrit ve polinöropati tabloları da bildirilmiştir. Bu çalışmada, akne tedavisi için izotretinoin tedavisi alan vve sakroiliit gelişen 23 yaşındaki bir kadın olgusunun sunulması amaçlanmıştır.

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“…Systemic retinoids are commonly prescribed for the treatment of severe acne vulgaris. However, they have some side effects (1), sacroiliitis being rare (2)(3)(4)(5)(6)(7). Until now, isotretinoin induced sacroiliitis has been documented in a limited number of patients and in most of them it was bilaterally (2-7).…”

Section: Bilateral Sacroiliitis Induced By Systemic Isotretinoin Treamentioning

confidence: 99%