Laboratory tests in patients treated with isotretinoin: occurrence of liver and muscle abnormalities and failure of AST and ALT to predict liver abnormality
Current laboratory monitoring may not be optimal. A retrospective chart review was performed on thelaboratory results of 246 patients who were treated with isotretinoin for acne over a 9-year period. Tests obtained were CBC, lipid panel, AST, ALT, CK, GGT,and C-reactive protein. Thirty-five patients...
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| Veröffentlicht in: | Dermatology online journal 2017-05, Vol.23 (5) |
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| creator | Webster, Guy F Webster, Timothy G Grimes, Lorraine R |
| description | Current laboratory monitoring may not be optimal. A retrospective chart review was performed on thelaboratory results of 246 patients who were treated with isotretinoin for acne over a 9-year period. Tests obtained were CBC, lipid panel, AST, ALT, CK, GGT,and C-reactive protein. Thirty-five patients had an elevated AST and 35 of these had an elevated CK; 32 had an elevated ALT and 11 of these had an elevated CK. Thirteen patients had an elevated GGT; in 5 this was the only abnormality, whereas 8 had a GGT elevation accompanied by an elevated AST or ALT. Two had an elevated GGT and an elevated CK with normal AST and ALT. Fifty-two patients had a single episode of elevated CK, of which 22 were female. However, 57 had multiple CK elevations and only one was female. Thirty-five patients had CK elevations |
| doi_str_mv | 10.5070/D3235034929 |
| format | Article |
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A retrospective chart review was performed on thelaboratory results of 246 patients who were treated with isotretinoin for acne over a 9-year period. Tests obtained were CBC, lipid panel, AST, ALT, CK, GGT,and C-reactive protein. Thirty-five patients had an elevated AST and 35 of these had an elevated CK; 32 had an elevated ALT and 11 of these had an elevated CK. Thirteen patients had an elevated GGT; in 5 this was the only abnormality, whereas 8 had a GGT elevation accompanied by an elevated AST or ALT. Two had an elevated GGT and an elevated CK with normal AST and ALT. Fifty-two patients had a single episode of elevated CK, of which 22 were female. However, 57 had multiple CK elevations and only one was female. Thirty-five patients had CK elevations <2 times normal; 38 had levels between 2 and 3 times normal, 18 had levels between 3 and 4 times normal, and 18 had levels greater than 4 times normal. We suggest that ALT and AST are not useful for monitoring isotretinoin therapy and that GGT and CK may be of greater value in managing patients.</description><identifier>ISSN: 1087-2108</identifier><identifier>EISSN: 1087-2108</identifier><identifier>DOI: 10.5070/D3235034929</identifier><identifier>PMID: 28537864</identifier><language>eng</language><publisher>United States</publisher><subject>Acne Vulgaris - drug therapy ; Alanine Transaminase - blood ; Aspartate Aminotransferases - blood ; Blood Cell Count ; C-Reactive Protein - metabolism ; Creatine Kinase - blood ; Dermatologic Agents - adverse effects ; Female ; gamma-Glutamyltransferase - blood ; Humans ; Isotretinoin - adverse effects ; Lipids - blood ; Male ; Monitoring, Physiologic - methods ; Retrospective Studies</subject><ispartof>Dermatology online journal, 2017-05, Vol.23 (5)</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c2419-ef318d0025aedbd55dc977ee65efb72663739283d90fd3444584baf97ebd5a933</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28537864$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Webster, Guy F</creatorcontrib><creatorcontrib>Webster, Timothy G</creatorcontrib><creatorcontrib>Grimes, Lorraine R</creatorcontrib><title>Laboratory tests in patients treated with isotretinoin: occurrence of liver and muscle abnormalities and failure of AST and ALT to predict liver abnormality</title><title>Dermatology online journal</title><addtitle>Dermatol Online J</addtitle><description>Current laboratory monitoring may not be optimal. A retrospective chart review was performed on thelaboratory results of 246 patients who were treated with isotretinoin for acne over a 9-year period. Tests obtained were CBC, lipid panel, AST, ALT, CK, GGT,and C-reactive protein. Thirty-five patients had an elevated AST and 35 of these had an elevated CK; 32 had an elevated ALT and 11 of these had an elevated CK. Thirteen patients had an elevated GGT; in 5 this was the only abnormality, whereas 8 had a GGT elevation accompanied by an elevated AST or ALT. Two had an elevated GGT and an elevated CK with normal AST and ALT. Fifty-two patients had a single episode of elevated CK, of which 22 were female. However, 57 had multiple CK elevations and only one was female. Thirty-five patients had CK elevations <2 times normal; 38 had levels between 2 and 3 times normal, 18 had levels between 3 and 4 times normal, and 18 had levels greater than 4 times normal. We suggest that ALT and AST are not useful for monitoring isotretinoin therapy and that GGT and CK may be of greater value in managing patients.</description><subject>Acne Vulgaris - drug therapy</subject><subject>Alanine Transaminase - blood</subject><subject>Aspartate Aminotransferases - blood</subject><subject>Blood Cell Count</subject><subject>C-Reactive Protein - metabolism</subject><subject>Creatine Kinase - blood</subject><subject>Dermatologic Agents - adverse effects</subject><subject>Female</subject><subject>gamma-Glutamyltransferase - blood</subject><subject>Humans</subject><subject>Isotretinoin - adverse effects</subject><subject>Lipids - blood</subject><subject>Male</subject><subject>Monitoring, Physiologic - methods</subject><subject>Retrospective Studies</subject><issn>1087-2108</issn><issn>1087-2108</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpNkUtLAzEUhYMotlZX7iVLQaqZPDoTd6U-oeDCuh4yyR2MzExqklH6X_yxxtaWbpJzk-8euOcidJ6Ra0FycnPHKBOEcUnlARpmpMjHNJ2He3qATkL4IIQSLtgxGtBCsLyY8CH6mavKeRWdX-EIIQZsO7xU0UKXdPSgIhj8beM7tsGlOtrO2e4WO61776HTgF2NG_sFHqvO4LYPugGsqs75VjU2OYX1R61s0_s1PX1drJ-m8wWODi89GKvj1mTXuTpFR7VqApz93yP09nC_mD2N5y-Pz7PpfKwpz-QYapYVJk0nFJjKCGG0zHOAiYC6yulkwnImacGMJLVhnHNR8ErVMocEK8nYCF1ufJfeffYphbK1QUPTqA5cH8pMEsqLjKagR-hqg2rvQvBQl0tvW-VXZUbKv3WUe-tI9MW_cV-1YHbsNn_2C-49h3c</recordid><startdate>20170515</startdate><enddate>20170515</enddate><creator>Webster, Guy F</creator><creator>Webster, Timothy G</creator><creator>Grimes, Lorraine R</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20170515</creationdate><title>Laboratory tests in patients treated with isotretinoin: occurrence of liver and muscle abnormalities and failure of AST and ALT to predict liver abnormality</title><author>Webster, Guy F ; Webster, Timothy G ; Grimes, Lorraine R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2419-ef318d0025aedbd55dc977ee65efb72663739283d90fd3444584baf97ebd5a933</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Acne Vulgaris - drug therapy</topic><topic>Alanine Transaminase - blood</topic><topic>Aspartate Aminotransferases - blood</topic><topic>Blood Cell Count</topic><topic>C-Reactive Protein - metabolism</topic><topic>Creatine Kinase - blood</topic><topic>Dermatologic Agents - adverse effects</topic><topic>Female</topic><topic>gamma-Glutamyltransferase - blood</topic><topic>Humans</topic><topic>Isotretinoin - adverse effects</topic><topic>Lipids - blood</topic><topic>Male</topic><topic>Monitoring, Physiologic - methods</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Webster, Guy F</creatorcontrib><creatorcontrib>Webster, Timothy G</creatorcontrib><creatorcontrib>Grimes, Lorraine R</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Dermatology online journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Webster, Guy F</au><au>Webster, Timothy G</au><au>Grimes, Lorraine R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Laboratory tests in patients treated with isotretinoin: occurrence of liver and muscle abnormalities and failure of AST and ALT to predict liver abnormality</atitle><jtitle>Dermatology online journal</jtitle><addtitle>Dermatol Online J</addtitle><date>2017-05-15</date><risdate>2017</risdate><volume>23</volume><issue>5</issue><issn>1087-2108</issn><eissn>1087-2108</eissn><abstract>Current laboratory monitoring may not be optimal. A retrospective chart review was performed on thelaboratory results of 246 patients who were treated with isotretinoin for acne over a 9-year period. Tests obtained were CBC, lipid panel, AST, ALT, CK, GGT,and C-reactive protein. Thirty-five patients had an elevated AST and 35 of these had an elevated CK; 32 had an elevated ALT and 11 of these had an elevated CK. Thirteen patients had an elevated GGT; in 5 this was the only abnormality, whereas 8 had a GGT elevation accompanied by an elevated AST or ALT. Two had an elevated GGT and an elevated CK with normal AST and ALT. Fifty-two patients had a single episode of elevated CK, of which 22 were female. However, 57 had multiple CK elevations and only one was female. Thirty-five patients had CK elevations <2 times normal; 38 had levels between 2 and 3 times normal, 18 had levels between 3 and 4 times normal, and 18 had levels greater than 4 times normal. We suggest that ALT and AST are not useful for monitoring isotretinoin therapy and that GGT and CK may be of greater value in managing patients.</abstract><cop>United States</cop><pmid>28537864</pmid><doi>10.5070/D3235034929</doi><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; EZB-FREE-00999 freely available EZB journals |
| subjects | Acne Vulgaris - drug therapy Alanine Transaminase - blood Aspartate Aminotransferases - blood Blood Cell Count C-Reactive Protein - metabolism Creatine Kinase - blood Dermatologic Agents - adverse effects Female gamma-Glutamyltransferase - blood Humans Isotretinoin - adverse effects Lipids - blood Male Monitoring, Physiologic - methods Retrospective Studies |
| title | Laboratory tests in patients treated with isotretinoin: occurrence of liver and muscle abnormalities and failure of AST and ALT to predict liver abnormality |
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