Labiris Georgios, Katsanos Andreas, Karapetsa Maria, Mpanaka Ioanna, Chatzoulis Dimitrios
Ophthalmology Department, University Hospital of Larissa, 41110 Larissa, Greece.
J Med Case Rep. 2009 Feb 10;3:58. doi: 10.1186/1752-1947-3-58.
We report an adolescent boy with minimal pre-existing risk for thromboses who suffered central retinal vein occlusion associated with isotretinoin use for acne. To the best of our knowledge, this is the first well documented case of this association.
An otherwise healthy 17-year-old white man who was treated with systemic isotretinoin for recalcitrant acne was referred with central retinal vein occlusion in one eye. Although a detailed investigation was negative, DNA testing revealed that the patient was a heterozygous carrier of the G20210A mutation of the prothrombin gene. Despite the fact that this particular mutation is thought to represent only a minor risk factor for thromboses, it is probable that isotretinoin treatment greatly increased the risk of a vaso-occlusive incident in this patient.
Isotretinoin use may be associated with sight- and life-threatening thrombotic adverse effects even in young patients with otherwise minimal thrombophilic risk. Physicians should be aware of such potential dangers.
我们报告了一名青少年男性，其既往血栓形成风险极小，在使用异维A酸治疗痤疮时发生了视网膜中央静脉阻塞。据我们所知，这是该关联的首例有充分记录的病例。
一名17岁的白人男性，身体健康，因顽固性痤疮接受全身异维A酸治疗，因一只眼睛出现视网膜中央静脉阻塞前来就诊。尽管详细检查结果为阴性，但DNA检测显示该患者是凝血酶原基因G20210A突变的杂合携带者。尽管这种特定突变被认为只是血栓形成的一个次要危险因素，但异维A酸治疗很可能大大增加了该患者发生血管闭塞事件的风险。
即使在血栓形成风险极小的年轻患者中，使用异维A酸也可能与危及视力和生命的血栓性不良反应相关。医生应意识到此类潜在危险。
