Leukopenia and Neutropenia Associated With Isotretinoin Therapy

Friedman, Stephen J.

doi:10.1001/archderm.1987.01660270025004

Cited by 22 publications

(10 citation statements)

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“…Abnormalities in transaminase level may also be related to comorbid hepatic conditions, concomitant medical therapy, or alcohol consumption, which were not measured in the present study. While there have been published case reports of dramatic reductions in hematological parameters in the setting of isotretinoin use, 6,7,16 our results reveal very few abnormalities during treatment. We conclude that except for patients in whom a hematologic abnormality is suspected prior to or during treatment, the diagnostic yield of routine monitoring of WBC count, hemoglobin level, and platelet count during isotretinoin therapy is too low to be clinically useful.…”

Section: Cumulative Incidence Of Laboratory Abnormalities Among Patiecontrasting

confidence: 48%

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A Population-Based Analysis of Laboratory Abnormalities During Isotretinoin Therapy for Acne Vulgaris

Zane

Leyden²,

Marqueling³

et al. 2006

Arch Dermatol

140

124

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To determine the incidence of abnormal laboratory test results among isotretinoin users.Design: Retrospective cohort.Setting: Comprehensive managed care health plan in Northern California. Participants:The study population comprised 13 772 patients aged 13 to 50 years with acne, undergoing oral isotretinoin therapy between March 1995 and September 2002.Main Outcome Measures: Laboratory values for serum triglyceride, total cholesterol, and liver transaminase levels; white blood cell count, hemoglobin level, and platelet count; and frequency of abnormal laboratory results by severity grade as defined by the National Cancer Institute Common Terminology Criteria for Adverse Events v3.0.Results: Substantial increases in the cumulative incidence of abnormalities were seen in serum lipid and transaminase levels, but not in hematologic parameters, dur-ing isotretinoin treatment compared with the baseline period. The cumulative incidence of new abnormalities in patients with normal values at baseline was 44% for triglyceride level, 31% for total cholesterol level, and 11% for transaminase level. Moderate to severe abnormalities in lipid and transaminase levels were generally transient and reversible. New abnormalities in hematological test results were uncommon. Conclusions:The incidence of abnormally high serum lipid levels during isotretinoin treatment may be greater than previously estimated. Elevations in transaminase level are generally mild. Normal baseline values of serum lipid and transaminase levels do not preclude the development of new abnormalities during isotretinoin treatment. Routine monitoring of white blood cell count, hemoglobin level, and platelet count during isotretinoin therapy may be of little utility without clinical suspicion of an abnormality. The clinical significance of laboratory abnormalities during isotretinoin therapy remains to be determined.

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Section: Cumulative Incidence Of Laboratory Abnormalities Among Patiecontrasting

confidence: 48%

“…1 Case reports of such systemic complications as pancreatitis, 2-4 drug-induced hepatotoxicity, 5 leukopenia, 6 and thrombocytopenia 7 have prompted the widespread practice of frequent laboratory monitoring of patients undergoing isotretinoin therapy. However, 2 retrospective studies found little evidence for the use of routine laboratory testing.…”

mentioning

confidence: 99%

A Population-Based Analysis of Laboratory Abnormalities During Isotretinoin Therapy for Acne Vulgaris

Zane

Leyden²,

Marqueling³

et al. 2006

Arch Dermatol

140

124

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“…Besides these side effects, isotretinoin is known to cause several laboratory disturbances [8]. Severe hematological changes were previously reported as case reports [9–11]. However, there are no sufficient studies assessing the effect of the hematological parameters, especially on the platelets.…”

Section: Introductionmentioning

confidence: 99%

Effects of Isotretinoin on the Platelet Counts and the Mean Platelet Volume in Patients with Acne Vulgaris

Ataseven¹,

Bilgin

2014

The Scientific World Journal

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Aim. The aim of this study was to evaluate the platelet counts and the mean platelet volume in patients who received isotretinoin for the treatment of acne vulgaris. Method. A total of 110 patients were included in this retrospective study. Complete blood count parameters were recorded prior to and three-months following the treatment. Results. Both platelet counts and the mean platelet volume were significantly decreased following the treatment. No significant differences were noted on the levels of hemoglobin, hematocrit, and white blood cell count. Conclusion. Platelet counts and mean platelet volume significantly decreased following isotretinoin treatment. Since the decrease of platelet counts and the mean platelet volume was seen concomitantly, it is concluded that the effect of isotretinoin was through the suppression of bone marrow.

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“…Agranulocytosis is found in a variety of infectious diseases (3), but studies in this patient failed to reveal an infectious trigger. Only a very few instances of hematologic adverse effects such as thrombocytopenia and agranulocytosis have been reported with isotretinoin (4,5). Periodic monitoring of serum triglycerides, cholesterol, and transaminases are recommended but no consensus exists on monitoring other laboratory parameters including complete blood count (1).…”

Section: Discussionmentioning

confidence: 99%