Premature epiphyseal closure—a complication of etretinate therapy in children

Prendiville, Julie; Bingham, E.A.; Burrows, D.

doi:10.1016/s0190-9622(86)70300-9

Cited by 100 publications

(56 citation statements)

References 8 publications

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“…In another example, retinoids are commonly used to treat cancer and skin problems, such as acne and hyperkeratotic disorders. Several reports in children exposed to retinoids have shown premature epiphyseal closure, mainly in lower limbs, with consequent development of short stature, usually around 4-5 years after a highdose treatment (105,106,107). Those findings were supported by animal models of hypervitaminosis A in rats and of use of retinoids in guinea pigs, showing a direct effect in epiphyseal plate (108).…”

Section: Treatmentmentioning

confidence: 89%

MANAGEMENT OF ENDOCRINE DISEASE: Diagnostic and therapeutic approach of tall stature

Albuquerque

Scalco

Jorge

2017

European Journal of Endocrinology

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Tall stature is defined as a height of more than 2 standard deviations (s.d.) above average for same sex and age. Tall individuals are usually referred to endocrinologists so that hormonal disorders leading to abnormal growth are excluded. However, the majority of these patients have familial tall stature or constitutional advance of growth (generally associated with obesity), both of which are diagnoses of exclusion. It is necessary to have familiarity with a large number of rarer overgrowth syndromes, especially because some of them may have severe complications such as aortic aneurysm, thromboembolism and tumor predisposition and demand-specific follow-up approaches. Additionally, endocrine disorders associated with tall stature have specific treatments and for this reason their recognition is mandatory. With this review, we intend to provide an up-to-date summary of the genetic conditions associated with overgrowth to emphasize a practical diagnostic approach of patients with tall stature and to discuss the limitations of current growth interruption treatment options.

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Section: Treatmentmentioning

confidence: 89%

MANAGEMENT OF ENDOCRINE DISEASE: Diagnostic and therapeutic approach of tall stature

Albuquerque

Scalco

Jorge

2017

European Journal of Endocrinology

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“…Targeted X-rays for atypical musculoskeletal pain may be informative. Concern about the use of acitretin in children has arisen from occasional reports of bone changes, including premature epiphyseal closure, 108 skeletal hyperostosis and extraosseous calcification in children on long-term treatment with etretinate. 109 It should be noted that very high dose exposure in one case led to osteopenia and fractures in the bones that fused prematurely and in the other case premature closure was a symptomless observation on X-rays.…”

Section: Skeletal Abnormalitiesmentioning

confidence: 99%

“…109 It should be noted that very high dose exposure in one case led to osteopenia and fractures in the bones that fused prematurely and in the other case premature closure was a symptomless observation on X-rays. 108 Five children treated with etretinate had periosteal thickening in the fibula, ulna, metacarpal or metatarsal bones that either developed or progressed on therapy. Compared with age-and sex-matched normal controls, the children had decreased cortical bone thickness of the second left metacarpal bone.…”

Section: Skeletal Abnormalitiesmentioning

confidence: 99%

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British Association of Dermatologists guidelines on the efficacy and use of acitretin in dermatology

Ormerod

Campalani

Goodfield

2010

British Journal of Dermatology

126

154

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“…2 mg/kg/gün dozunda etretinat kullanan 7 çocuk hastadan birinde travmatik k›r›k bildirmifllerdir. Bu çocukta etretinat tedavisi kesilmemifl ve k›r›klar beklenen sürede iyileflmifllerdir 11,12 . ‹lginç olarak son y›llarda literatürde birçok yazar, bu olgu bildirimlerinin tersine kronik retinoid kullanan hastalar›nda herhangi bir kemik toksisitesi veya büyüme gerili¤i saptamad›klar›n› bildirmifllerdir.…”

Section: Tart›flmaunclassified

Systemic Retinoid Treatment in Childhood Psoriasis: Experience of 19 Mayıs University

Özden¹,

Denizli²,

Aydın³

et al. 2010

turkderm

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ÖzetAmaç: Çocukluk ça¤›nda görülen fliddetli plak tip psoriasis, önemli bir morbiditeye sahiptir ve bu konuda çok az bilgi olmas›na ra¤-men sistemik tedavi kullan›lmas›n› gerektirmektedir. Bu çal›flmada fliddetli psoriasis klini¤i olan çocuklarda asitretin tedavisinin sonuçlar›n› göstermeyi amaçlad›k. Gereç ve Yöntem: Ondokuz May›s Üniversitesi Hastanesi'nde psoriasis vulgaris nedeniyle asitretin tedavisi alan 18 çocuk olgu geriye dönük olarak de¤erlendirildi. Olgular›n tedaviye verdikleri yan›tlar, toplam tedavi süreleri ve dozlar› kaydedildi. Bu klinik verilerin d›fl›nda, olgular›n tüm takip dönemlerine ait laboratuvar tetkikleri ile birlikte uzun süre asitretin tedavisi alan 3 olguya ait "kemik survey" incelemeleri de¤erlendirildi. Bulgular: ‹ncelenen 18 olgunun psoriasis lezyonlar› 2'sinde (%11,1) tamamen, 10'unda(%55,5) büyük ölçüde gerilemiflti. Asitretin tedavisi 2 olguda toplam 2 kür (11 ve 12 ay), 1 olguda toplam 15 ay süreyle olmak üzere 3 kür ve 1 olguda toplam 24 ay sü-reyle olmak üzere 5 kür olarak verilmesi gerekti¤i gözlendi. ‹ki olgu mukokütanöz yan etkiler nedeniyle tedavinin 4. ve 5. ay›n-da ilac› kesmiflti. Olgularda bunun d›fl›nda herhangi bir yan etki saptanmad›. Sonuç: Çocukluk ça¤› psoriasis olgular›nda asitretin tedavisi, dikkatli bir izlemle verildi¤inde güvenilir ve etkili bir tedavi seçene-¤idir. (Türkderm 2010; 44: 79-82) Anahtar Kelimeler: Çocukluk ça¤›, psoriasis, retinoid, asitretin, tedavi SummaryBackground and Design: Severe psoriasis in childhood has a significant morbidity and can warrant the use of systemic agents, although there are very little information in this group. We aimed to show the results of acitretin treatment in children with severe psoriasis, in this study. Material and Method:We have retrospectively reviewed the notes of all 18 children treated with acitretin at Ondokuz May›s University Hospital. Patients' responses to treatment, total treatment durations and acitretine dosage were recorded. Additionally, the laboratory results during the whole follow-up period and bone surveys for 3 patients who received long term treatment were evaluated. Results: Of the 18 patients reviewed, 2 (%11.1) responded with clearance of psoriasis, 10 (%55.5) responded well with small residual plaques. Two patients needed two courses of acitretine (11 and 12 months), 1 patient needed three courses for 15 months and 1 needed 5 courses for 24 months. Two patients stopped treatment due to mucocutaneous side effects at 4th and 5 th months. There were no other adverse events. Conclusion: We propose that when carefully monitored, acitretine is a safe and efficacious treatment option for severe psoriasis in children. (Turkderm 2010; 44: 79-82)

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Premature epiphyseal closure—a complication of etretinate therapy in children

Cited by 100 publications

References 8 publications

MANAGEMENT OF ENDOCRINE DISEASE: Diagnostic and therapeutic approach of tall stature

MANAGEMENT OF ENDOCRINE DISEASE: Diagnostic and therapeutic approach of tall stature

British Association of Dermatologists guidelines on the efficacy and use of acitretin in dermatology

Systemic Retinoid Treatment in Childhood Psoriasis: Experience of 19 Mayıs University

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