Severe hepatotoxic reaction with progression to cirrhosis after use of a novel retinoid (acitretin)

Ditzhuijsen, Th. J. M. van; Haelst, U.J.G.M. van; Dooren‐Greebe, R.J. van; Kerkhof, P.C.M. van de; Yap, Sing Hiem

doi:10.1016/0168-8278(90)90111-4

Cited by 42 publications

(10 citation statements)

References 11 publications

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“…Similar results were reported in liver and kidney tissues of rats received oral acitretin for three months [9][10][11]. Van Ditzhuijsen et al [34] indicated severe histological manifestations followed treatment with acitretin in a 50-year-old female. The vacuolations of enterocytes observed in this work was confirmed by Cheville [35] who conducted that these cytoplasmic vacuoles are responsible for collecting the injurious elements and preventing them from interfering with the biological activities of cells.…”

Section: Discussionsupporting

confidence: 79%

Adverse Effects of Soriatane on Rats Enterocytes: Light Microscopy and Ultrastructural Studies

Hummadi¹

2012

J Cytol Histol

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Soriatane (Acitretin) drug is a synthetic vitamin A analogue and the main metabolite of etretinate. It is considered to be the latest medicine prescribed to psoriasis patients. However, it is not used frequently because of its side-effect profile. Little is known about the Acitretin intestinal toxicity, so the objective of this study is evaluation of soriatane adverse events in daily practice treatment on the duodenum enterocytes of male rats. Two groups each of 10 Wistar male rats (5-6 weeks old), one of them is the treated group and the other is the control group. The drug was dissolved immediately in distilled water before administration, and given to treated rats by gastric intubation in the morning (0.2 mg/kg/day for 12 months), while the control group received only distilled water. A significant reduction in number and height of villi with increased mucosal thickness. Damage in the duodenum tissues with villi fusion, distortion flattened epithelial cells; intense lamina propria and edema were observed. The ultra-structure alterations were indicated by Golgi apparatus, rough endoplasmic reticulum and mitochondrial atrophy with cristiolysis. Proliferation of smooth endoplasmic reticulum, nuclear deformity and increased number of liposomes were also noted. It may concluded that Soriatane led to irreversible ultra-structural alterations in rat enterocytes after 12 months treatment and precautions should be taken in prescribing acitretin to patients.

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Section: Discussionsupporting

confidence: 79%

Adverse Effects of Soriatane on Rats Enterocytes: Light Microscopy and Ultrastructural Studies

Hummadi¹

2012

J Cytol Histol

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“…A liver biopsy study did not reveal a significant risk for liver toxicity in patients treated with acitretin (49). Severe increases of liver functions are rare, but may indicate toxic hepatitis induced by acitretin (50).…”

mentioning

confidence: 99%

Update on retinoid therapy of psoriasis in: an update on the use of retinoids in dermatology

Kerkhof

2006

Dermatol Ther

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Both in the topical and systemic treatment of psoriasis, retinoids are mainstays. In this chapter the history and modes of actions of retinoids are presented. Tazarotene and acitretin are the only retinoids that are available in both topical and systemic formulations. A more extensive description of their pharmacology, modes of action, indications and contraindications, clinical results, and treatment strategies will be presented. Finally, retinoid X receptor ligands and retinoic acid metabolism blocking agents will be introduced as potential future retinoid mimetics in psoriasis.

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“…128 Severe increases of liver function test results are rare, but may indicate toxic hepatitis induced by acitretin. 129 Diffuse idiopathic hyperostosis has rarely been reported as a side effect of systemic retinoids. It is characterized by degenerative spondylosis, arthritis of the vertebral articulations, and syndesmophytes of the vertebral spine, and extra spinal bones with bone spur formation.…”

Section: Safetymentioning

confidence: 99%

Guidelines of care for the management of psoriasis and psoriatic arthritis

Menter¹,

Korman²,

Elmets³

et al. 2009

Journal of the American Academy of Dermatology

491

161

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Severe hepatotoxic reaction with progression to cirrhosis after use of a novel retinoid (acitretin)

Cited by 42 publications

References 11 publications

Adverse Effects of Soriatane on Rats Enterocytes: Light Microscopy and Ultrastructural Studies

Adverse Effects of Soriatane on Rats Enterocytes: Light Microscopy and Ultrastructural Studies

Update on retinoid therapy of psoriasis in: an update on the use of retinoids in dermatology

Guidelines of care for the management of psoriasis and psoriatic arthritis

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