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Isotretinoin as a Possible Environmental Trigger to Autoimmunity in Genetically
Susceptible Patients
#MMPMID28458939
Nugroho J
; Schweiger B
Case Rep Pediatr
2017[]; 2017
(?): 4207656
PMID28458939
show ga
Introduction. Isotretinoin is commonly used to treat cystic acne. Definitive
mechanisms of action for isotretinoin are not known though despite many side
effects having been documented. Various case reports have noted autoimmune
diseases succeeding isotretinoin treatment. Case Report. A 16-year-old female
presents with symptoms of tremors, lack of focus, sleeplessness, emotional
liability, bulging eyes, loose stools, heat intolerance, and missed menstrual
periods. Symptoms manifested shortly after the patient finished a course of oral
isotretinoin treatment for acne. Physical exam showed resting tremors, bilateral
proptosis, hyperactivity, and rapid speech. A diagnosis of Graves' Disease was
made by correlating symptoms, physical exam findings, ultrasound, and positive
family history of autoimmune thyroid disease. Conclusion. Emergence of autoimmune
thyroid diseases depends upon genetic predisposition and environmental triggers.
Mechanism of action for isotretinoin is not known but the drug may play a role in
triggering autoimmunity in genetically susceptible individuals.