Isotretinoin‐Induced Agranulocytosis

Özdemır, Mehmet Akif; Köse, Mehmet; Karakükçü, Musa; Ferahbaş, Ayten; Patıroğlu, Türkan; Köklü, Esad

doi:10.1111/j.1525-1470.2007.00468.x

Cited by 14 publications

(4 citation statements)

References 5 publications

(4 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There were three cases of agranulocytosis or neutropenia. In two cases isotretinoin was felt to be the probable trigger; 50,51 however, in the third case the patient displayed an ongoing mild neutropenia for 30 weeks despite drug cessation, suggesting that benign ethnic neutropenia or cyclical neutropenia may be more likely 52 …”

Section: Methodsmentioning

confidence: 99%

Is routine laboratory testing in healthy young patients taking isotretinoin necessary: a critically appraised topic

Affleck

Jackson

Williams

et al. 2022

British Journal of Dermatology

View full text Add to dashboard Cite

Summary Clinical question Is monitoring of liver function, lipids and full blood count necessary in healthy people taking isotretinoin? Background Routine blood testing was recommended in the original licence for Roaccutane™ (isotretinoin) in 1983. In recent years, less frequent monitoring has been suggested by various authors. Data sources We performed four individual systematic searches of the MEDLINE database, via PubMed, from origin to 2 May 2021, supplemented by a hand search of all references in the identified papers. Study selection Inclusion criteria were any description of clinical symptoms, laboratory abnormalities and/or physical findings, and any paper that explicitly described the patients as asymptomatic, during treatment with oral isotretinoin. Data extraction Two independent reviewers (J.A. and D.J.) assessed articles for eligibility of inclusion. Evaluation of the data was done also by two of the authors (A.A., D.J. and J.A.) for each section, with the aim to use the presented evidence including guidelines, databases, case series, case reports, cohort studies and randomized clinical trials to delineate the clinical presentation and frequency of adverse events that might be amenable to laboratory monitoring. Results We identified 407 papers in our searches and reviewed 125 papers in four sections. Overall, reported adverse events were very rare (< 1 in 10 000) and were either idiosyncratic or not preventable by monitoring, accompanied by symptoms, or seen in identifiable predisposed individuals who might benefit from monitoring because of pre‐existing conditions. Recommendation for clinical care We could not find evidence to support the benefit of monitoring to detect adverse events. We suggest that in healthy young people laboratory monitoring for oral isotretinoin is unnecessary and risks detecting nonserious biochemical abnormalities. However, we recognize that new information about adverse events may change that recommendation.

show abstract

Section: Methodsmentioning

confidence: 99%

Is routine laboratory testing in healthy young patients taking isotretinoin necessary: a critically appraised topic

Affleck

Jackson

Williams

et al. 2022

British Journal of Dermatology

View full text Add to dashboard Cite

show abstract

“…There are also case reports describing hematological side effects, such as isotretinoin-induced thrombocytosis, prolonged thrombocytopenia, agranulocytosis, and neutropenia, 7,8,9,14,15,16,17 and therefore, clinicians usually tend to evaluate hemogram parameters. In studies on hematological parameters, comparisons have been usually made between the values measured before treatment and at the third month of treatment, and different results have been reported.…”

Section: Ta B L E 3 P Values For the Multiple Comparison Of Parameter...mentioning

confidence: 99%

Evaluation of hematological parameters in patients using systemic isotretinoin with diagnosis of acne vulgaris

Saadet

Ugur

2022

J of Cosmetic Dermatology

View full text Add to dashboard Cite

Objectives Oral isotretinoin is the most effective treatment option in patients with acne. However, it can cause various hematologic and biochemical abnormalities. This study aimed to evaluate hematologic abnormalities during oral isotretinoin treatment in patients with acne. Material and Methods In this cross‐sectional study, the hematologic and inflammatory parameters of 138 patients with acne using 0.3‐1 mg/kg/day oral isotretinoin for at least 6 months were retrospectively analyzed. Results In the study, the female‐to‐male ratio was 2.83, and the mean age of the patients was 23.1 ± 5.8 years. At the third and sixth months of isotretinoin treatment, there was a statistically significant decrease in the neutrophil count compared to the pre‐treatment values (p = 0.003 and p = 0.032, respectively). The platelet count showed the most statistically significant increase (p < 0.001) at the first month of treatment. The most statistically significant decrease in the neutrophil‐to‐lymphocyte ratio (NLR) was observed at the third month of treatment (p < 0.001). No significant changes were observed in hemoglobin, hematocrit, white blood cell count, mean corpuscular volume, and mean platelet volume. Conclusions There was a decrease in neutrophils and NLR and an increase in platelets during isotretinoin treatment, and these changes were usually mild. However, it would be appropriate to monitor blood counts during treatment in patients with neutropenia or thrombocytosis.

show abstract

“…[4] Reports of severe leukopenia and or thrombocytopenia are likely idiosyncratic. [5,6] Lipid abnormalities are the most common laboratory abnormality seen with isotretinoin therapy. [7] The patients must be evaluated carefully at the beginning of systemic isotretinoin treatment;…”

Section: Introductionmentioning

confidence: 99%

Sistemik İsotretinoin Tedavisi Alan Akne Vulgaris Hastalarında Nötrofil- Lenfosit Oranı ve C-Reaktif Protein Düzeyleri

Yavuz¹

2021

Journal of Contemporary Medicine

View full text Add to dashboard Cite

Introduction: Inflammatory mediators have importance in acne vulgaris pathogenesis. Which mediators cause lesions or increase with which variants is not clear. Neutrophil-lymphocyte ratio and C-reactive protein are the inflammatory indicators that used for follow up of inflammatory diseases. There are various studies state that neutrophil-lymphocyte ratio and C-reactive protein levels are important for systemic isotretinoin treatment or not. Evaluation of changes in neutrophil-lymphocyte ratio and C-reactive protein levels with systemic isotretinoin treatment is the aim of this study. Material andMethod: Acne vulgaris patients who are treated with systemic isotretinoin and healthy control subjects between January 2006 and December 2016 in Konya Training and Research Hospital Dermatology outpatient clinic are included to study. Neutrophillymphocyte ratio and C-reactive protein levels compared in each group at the beginning of treatment and at the 3rd month.Results: 50 patients (28 of women and 22 of men) who are treated with systemic isotretinoin for acne vulgaris and 50 healthy control patients (21 of women and 29 of men) included to study. Mean age of treatment group was 21 (19-23) and control group was 29,5. Neutrophil-lymphocyte ratio are not found statistically significiant in patients and control group at the begining and middle of the treatment (1,84,[3,36-0,51] -1,62,[4,07-0,68], p:0,107), C-reactive protein levels show a statistically significiant decrease in patient group with treatment (p<0,028). Conclusion:Systemic isotretinoin treatment may affect neutrophillymphocyte ratio and C-reactive protein levels in patients. Further studies are needed to clarify this relation.

show abstract

Isotretinoin‐Induced Agranulocytosis

Cited by 14 publications

References 5 publications

Is routine laboratory testing in healthy young patients taking isotretinoin necessary: a critically appraised topic

Is routine laboratory testing in healthy young patients taking isotretinoin necessary: a critically appraised topic

Evaluation of hematological parameters in patients using systemic isotretinoin with diagnosis of acne vulgaris

Sistemik İsotretinoin Tedavisi Alan Akne Vulgaris Hastalarında Nötrofil- Lenfosit Oranı ve C-Reaktif Protein Düzeyleri

Contact Info

Product

Resources

About