Nizam Anjala, Gaballah Sarah, Al Ozaibi Labib, Raman Lakshmiah G
Department of Medicine and Surgery, Dubai Academic Health Corporation, Dubai, ARE.
Department of General Surgery, Rashid Hospital, Dubai, ARE.
Cureus. 2023 Jul 29;15(7):e42649. doi: 10.7759/cureus.42649. eCollection 2023 Jul.
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.
一名39岁女性患者因重度痤疮服用异维A酸约六个月，出现严重上腹部疼痛及腹胀。最初，超声检查发现胆结石，她被诊断为急性胆囊炎。然而，进一步的影像学检查显示肠壁增厚，为此她接受了进一步检查。实验室检查显示炎症标志物升高以及嗜酸性粒细胞增多。同时，床边腹腔穿刺显示嗜酸性粒细胞水平升高。患者接受了内镜评估，结果显示为嗜酸性食管炎和胃肠炎，可能由异维A酸诱发。停用异维A酸并开始使用皮质类固醇治疗后，患者的临床状况显著改善。对于长期服用异维A酸或存在其他风险因素且出现吞咽困难、腹痛、吞咽痛、恶心和呕吐等症状的患者，必须考虑到嗜酸性胃肠道疾病的诊断，尽管这种疾病很罕见。
