isotretinoin and Weight-Loss

To report a case of inflammatory bowel disease (IBD) associated with use of isotretinoin.. 17-year-old boy presented with new-onset rectal bleeding after completion of a five-month course of isotretinoin. A diagnosis of ulcerative colitis was made. His condition worsened despite therapy with 5-aminosalicylic acid, steroid retention enema, iron supplement, and prednisone. Five months after the onset of rectal bleeding, he had lost 11.4 kgand developed bilateral pitting edema of the hips and profound anemia. A subtotal colectomy and ileostomy was performed.. Rectal bleeding has been reported to occur during or up to several years after treatment with isotretinoin. The mechanism by which isotretinoin may induce IBD is unknown. Proposed mechanisms include inhibition of epithelial cell growth resulting in ulceration and inflammation of the gut mucosa, inhibition of glycoprotein synthesis affecting the integrity of the mucosal wall, and stimulation of kiler T cells, leading to epithelial cell injury and a resultant inflammatory response.. This case of probable isotretinoin-induced IBD suggests that patients with suspected IBD should be asked about current or past use of isotretinoin to improve documentation of this serious adverse event.

Topics: Acne Vulgaris; Adolescent; Adult; Colitis, Ulcerative; Female; Humans; Inflammatory Bowel Diseases; Isotretinoin; Male; Weight Loss

A recent clinical protocol combining retinoic acid, interferon, and radiotherapy for advanced cervical cancer produced proctitis severe enough to necessitate dose reductions. In an attempt to model this biological response to multimodality therapy, we used a murine model to study the response of the colonic epithelium. Mice were treated with retinoic acid (100 micrograms/day) and interferon (3 x 10(4) units/day) for 5 days before undergoing whole-body irradiation. The functional response of the bowel was assessed by the ability to maintain body weight, and reproductive cell survival was quantified by the colon crypt assay. Both assays indicated a moderate protective effect of treatment with retinoic acid and interferon prior to irradiation. Protection factors in the range of 1.1-1.4 were observed.

Topics: Animals; Cell Survival; Clone Cells; Female; Interferon alpha-2; Interferon-alpha; Isotretinoin; Mice; Mice, Inbred C3H; Radiation Injuries, Experimental; Radiation-Protective Agents; Recombinant Proteins; Weight Loss