Perinuclear antineutrophil cytoplasmic antibody-positive vasculitis, oligoarthritis, tendinitis, and myositis associated with isotretinoin in a 15-year-old boy: Case report and review of literature

Pediatr Dermatol. 2018 May;35(3):e173-e177. doi: 10.1111/pde.13445. Epub 2018 Apr 11.

Abstract

We present a patient in whom a combination of perinuclear antineutrophil cytoplasmic antibody-positive vasculitis, oligoarthritis, tendinitis, and myositis was considered to be associated with isotretinoin use. Discontinuation of the drug resulted in complete clinical and biochemical remission (normalization of perinuclear antineutrophil cytoplasmic antibody titer). Although we were unable to prove causality, no other underlying cause for the patient's course was found. We report this occurrence to bring it to the attention of physicians prescribing isotretinoin.

Keywords: arthritis; isotretinoin; myositis; p-ANCA; retinoid; tendinitis; vasculitis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Acne Vulgaris / drug therapy
  • Adolescent
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Antibodies, Antineutrophil Cytoplasmic / blood
  • Arthritis / chemically induced*
  • Arthritis / complications
  • Dermatologic Agents / adverse effects*
  • Diagnosis, Differential
  • Humans
  • Isotretinoin / adverse effects*
  • Magnetic Resonance Imaging
  • Male
  • Myositis / chemically induced*
  • Myositis / complications
  • Skin / pathology
  • Tendinopathy / chemically induced*
  • Tendinopathy / complications
  • Vasculitis / chemically induced*
  • Vasculitis / complications
  • Withholding Treatment

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Antibodies, Antineutrophil Cytoplasmic
  • Dermatologic Agents
  • Isotretinoin