Presumed isotretinoin-induced, concomitant autoimmune thyroid disease and ocular myasthenia gravis: A case report


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Gursoy H. H., Cakmak I., YILDIRIM N., Basmak H.

Case Reports in Dermatology, cilt.4, sa.3, ss.256-260, 2012 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 4 Sayı: 3
  • Basım Tarihi: 2012
  • Doi Numarası: 10.1159/000345680
  • Dergi Adı: Case Reports in Dermatology
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.256-260
  • Anahtar Kelimeler: Isotretinoin, Ocular myasthenia gravis, Thyroiditis
  • Eskişehir Osmangazi Üniversitesi Adresli: Evet

Özet

© 2012 S. Karger AG, Basel.Introduction: There are many adverse effects that have been described for isotretinoin. To the best of our knowledge, this is the first report of a possible association of oral isotretinoin intake with autoimmune thyroiditis and ocular myasthenia gravis (OMG). Case Presentation: A 19-year-old Caucasian male, who had used oral isotretinoin for severe acne disease for the previous six months, was referred to our clinic. He had a three-week history of diplopia and variable bilateral ptosis. Physical examination showed moderate periorbital edema and limitations of up- and down-gaze in the left eye. Laboratory findings and thyroid ultrasound were consistent with autoimmune thyroiditis. Antithyroid therapy did not relieve the clinical symptoms. Concomitant OMG was suspected. Variable ptosis and a positive response to oral prednisolone of 40 mg/day and pyridostigmine of 360 mg/day supported the diagnosis of concomitant autoimmune thyroiditis and OMG. Conclusion: Autoimmune disorders may be triggered by oral isotretinoin treatment. Clinicians prescribing isotretinoin should be aware of the possible association between isotretinoin intake and concomitant autoimmune thyroiditis and OMG.