Isotretinoin as a Possible Cause for Eosinophilic Esophagitis and Eosinophilic Gastroenteritis: A Case Report

A 39-year-old female patient who took isotretinoin for severe acne for around six months presented with severe upper abdominal pain, as well as abdominal distention. Initially, she was diagnosed with acute cholecystitis due to the presence of gallstones on ultrasound. However, additional imaging showed mural thickening of the bowel, for which she underwent further work-up. Laboratory investigations showed raised inflammatory markers along with eosinophilia. Concurrently, bedside paracentesis showed raised levels of eosinophils. The patient underwent an endoscopic assessment, which revealed eosinophilic esophagitis and gastroenteritis likely to be induced by isotretinoin. Following the discontinuation of isotretinoin and the initiation of corticosteroid therapy, the patient's clinical condition improved significantly. The diagnosis of eosinophilic gastrointestinal disorders, though rare, must be kept in mind when patients on long-term isotretinoin treatment or with other risk factors present with symptoms such as dysphagia, abdominal pain, odynophagia, nausea, and vomiting.