Prolonged Serum Alanine Aminotransferase Elevation Associated with Isotretinoin Administration. (17th July 2019)

• Record Type: Journal Article
• Authors: Nazarian, Roya S.; Zheng, Elizabeth; Halverstam, Caroline; Cohen, Steven R.; Wolkoff, Allan W.
• Other Names: Chebli Julio M. F. Academic Editor.
• Is Part Of: Case reports in hepatology. Volume 2019(2019)
• Publication Date: 2019-07-17
• Subjects: Liver -- Periodicals; Liver -- Diseases -- Periodicals; Liver Diseases; Liver; Liver; Liver -- Diseases; Periodicals; Periodicals; Case Reports; Fulltext; Internet Resources; Periodicals; 616.36
• DOI: 10.1155/2019/9270827
• Languages: English
• ISSNs: 2090-6587

Abstract

Abstract : 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.