Skip to main content
Key Specialties
Anesthesiology Cardiology Dermatology Diabetology Endocrinology Gastroenterology and Hepatology General Medicine Geriatrics Hematology Infectious Diseases Internal Medicine Nephrology Neurology Obstetrics and Gynecology Oncology Ophthalmology Pediatrics Psychiatry Radiology Respiratory Medicine Rheumatology Surgery Urology
Congress Coverage
ASH 2024 Annual Meeting 2024 ESMO Congress 2024 ERS Congress 2024 EASD Congress 2024 ESC Congress 2024 EAN Congress 2024 ASCO Annual Meeting 2024 ACC Congress
Clinical Collections
Advances in Alzheimer’s

Podcast | Sexual health in older age

Dr Holly Thomas helps us unpack the needlessly taboo subject of sex and sexual health in women of older age.

Listen now
ADVANCED SEARCH
Log in
Top
Journal of Medical Case Reports
Published in:

Open Access 21-02-2025 | Acute Pancreatitis | Case report

Isotretinoin-induced pancreatitis: is it time to definitely recognize it: a case report

Authors: Julien Barras, Maxime Poncin, Pierrette Gast, Édouard louis, Jean-Philippe Loly

Published in: Journal of Medical Case Reports | Issue 1/2025

Login to get access

Abstract

Background

Although often overlooked, drug-induced pancreatitis is a frequent cause of pancreatitis. Pancreatic drug toxicity is defined according to the classification by Mallory et al. and Trivedi et al. Isotretinoin is only classified as possibly toxic to the pancreas (class 3). We report the first case of recurrence of pancreatitis after rechallenge, which argues for a modification of the classification of drug-induced pancreatitis.

Case presentation

We present here the case of a 20-year-old Belgian man who suffered several episodes of acute pancreatitis for which no etiology could be identified despite an exhaustive assessment. Eventually, as a precaution, isotretinoin was discontinued and there was no recurrence until it was reintroduced.

Conclusion

This is the 25th case described in the literature, but the first with a positive rechallenge on two occasions. This case therefore implies that isotretinoin should definitely be considered a class 1 toxic drug for the pancreas and should be incriminated in acute pancreatitis in patients treated with this drug.
Literature
1.
Lankisch PG, Apte M, Banks PA. Acute pancreatitis. Lancet Lond Engl. 2015;386(9988):85–96.CrossRef
2.
3.
Yadav D, Lowenfels AB. Trends in the epidemiology of the first attack of acute pancreatitis: a systematic review. Pancreas. 2006;33(4):323–30.CrossRefPubMed
4.
Spanier BWM, Tuynman HARE, van der Hulst RWM, Dijkgraaf MGW, Bruno MJ. Acute pancreatitis and concomitant use of pancreatitis-associated drugs. Am J Gastroenterol déc. 2011;106(12):2183–8.CrossRef
5.
Jones E, Korzenko A, Kriegel D. Oral isotretinoin in the treatment and prevention of cutaneous squamous cell carcinoma. J Drugs Dermatol JDD. 2004;3(5):498–502.PubMed
6.
Ward A, Brogden RN, Heel RC, Speight TM, Avery GS. Isotretinoin a review of its pharmacological properties and therapeutic efficacy in acne and other skin disorders. Drugs. 1984;28(1):6–37.CrossRefPubMed
7.
Brelsford M, Beute TC. Preventing and managing the side effects of isotretinoin. Semin Cutan Med Surg sept. 2008;27(3):197–206.CrossRef
8.
Mallory A, Kern F. Drug-induced pancreatitis: a critical review. Gastroenterology avr. 1980;78(4):813–20.CrossRef
9.
Trivedi CD, Pitchumoni CS. Drug-induced pancreatitis: an update. J Clin Gastroenterol sept. 2005;39(8):709–16.CrossRef
10.
Flynn WJ, Freeman PG, Wickboldt LG. Pancreatitis associated with isotretinoin-induced hypertriglyceridemia. Ann Intern Med juill. 1987;107(1):63.CrossRef
11.
McCarter TL, Chen YK. Marked hyperlipidemia and pancreatitis associated with isotretinoin therapy. Am J Gastroenterol déc. 1992;87(12):1855–8.
12.
Aurousseau MH, Levacher S, Bénéton C, Blaise M, Pourriat JL. Transient dysfibrinogenemia and thrombocytopenia associated with recurrent acute pancreatitis in the course of isotretinoin therapy. Rev Med Interne. 1995;16(8):622–5.CrossRefPubMed
13.
Bourantas KL, Tsiara S, Christou L. Treatment of 34 patients with myelodysplastic syndromes with 13-CIS retinoic acid. Eur J Haematol. 1995;55(4):235–9.CrossRefPubMed
14.
Jamshidi M, Obermeyer RJ, Govindaraj S, Garcia A, Ghani A. Acute pancreatitis secondary to isotretinoin-induced hyperlipidemia. J Okla State Med Assoc févr. 2002;95(2):79–80.
15.
Fine JD, Johnson LB, Weiner M, Stein A, Suchindran C. Chemoprevention of squamous cell carcinoma in recessive dystrophic epidermolysis bullosa: results of a phase 1 trial of systemic isotretinoin. J Am Acad Dermatol avr. 2004;50(4):563–71.CrossRef
16.
17.
See SJ, Levin VA, Yung WKA, Hess KR, Groves MD. 13-cis-retinoic acid in the treatment of recurrent glioblastoma multiforme. Neuro-Oncol juill. 2004;6(3):253–8.CrossRef
18.
Greene JP. An adolescent with abdominal pain taking isotretinoin for severe acne. South Med J sept. 2006;99(9):992–4.CrossRef
19.
Pillai RN, Aisner J, Dahlberg SE, Rogers JS, DiPaola RS, Aisner S, et al. Interferon alpha plus 13-cis-retinoic acid modulation of BCL-2 plus paclitaxel for recurrent small-cell lung cancer (SCLC): an Eastern Cooperative Oncology Group study (E6501). Cancer Chemother Pharmacol juill. 2014;74(1):177–83.CrossRef
20.
Acute pancreatitis linked to isotretinoin. 2015 Prescrire Int. Févr 24(157):46.
21.
Tejedor Tejada J, Torres Yuste R, García PF. Acute pancreatitis secondary to treatment with isotretinoin. Gastroenterol Hepatol avr. 2019;42(4):256.CrossRef
22.
Atiq MU, Raza A, Ashfaq A. Idiosyncratic reaction causing a rare side effect: isotretenoin-induced pancreatitis. Cureus. 2019;11(11): e6102.PubMedPubMedCentral
23.
24.
Metadata
Title
Isotretinoin-induced pancreatitis: is it time to definitely recognize it: a case report
Authors
Julien Barras
Maxime Poncin
Pierrette Gast
Édouard louis
Jean-Philippe Loly
Publication date
21-02-2025
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2025
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/s13256-025-05097-2

Other articles of this Issue 1/2025

Multiple evanescent white dot syndrome masquerading as atypical optic neuritis: a case report

Hybrid nerve sheath tumor of the spinal canal and neurofibromatosis-2, where the twain shall meet—a case report and review of literature

Progressive multifocal leukoencephalopathy in rheumatoid arthritis and biological therapies: a case report and review of the literature

Management of chimeric antigen receptor T-cell-related toxicity of a patient affected by cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome, followed by an intestinal perforation: a case report

An idiopathic left internal iliac artery aneurysm in an 11-year-old boy: a case report

Pyopericardium with cardiac tamponade caused by pyogenic liver abscess: a case report

Image Credits