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阿维 A 致 Darier 病患者发生原发性甲状腺功能减退症:罕见病例报告。

Acitretin induced primary hypothyroidism in Darier's disease: A rare case report.

机构信息

Department of Pharmacy Practice, Karnataka College of Pharmacy, Bengaluru, Karnataka, India.

Department of Dermatology, Bangalore Baptist Hospital, Bengaluru, Karnataka, India.

出版信息

Indian J Pharmacol. 2024 May 1;56(3):220-223. doi: 10.4103/ijp.ijp_250_23. Epub 2024 Jul 5.

DOI:10.4103/ijp.ijp_250_23
PMID:39078187
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11286097/
Abstract

Acitretin is a synthetic, second-generation retinoid mainly used for the treatment of Darier's disease (DD), which impacts biological processes by binding to a nuclear receptor from the corticosteroid/thyroid receptor superfamily, thereby altering gene expression. Our report outlines the case of a 41-year-old male patient who has received a clinical diagnosis of DD and does not exhibit any other coexisting comorbidities, who developed hypothyroidism posttreatment with acitretin, an unusual and rare side effect of the drug. His baseline routine investigations fell within normal limits before the initiation of acitretin. Acitretin-induced hypothyroidism was treated with thyroxine. Although a good therapeutic response was seen with acitretin, it could not be continued due to the development of side effects and was continued on topical therapy. This case emphasizes the likelihood of adverse effects linked to therapeutic levels of acitretin in patients without any prior history and signifies the critical importance of consistent blood monitoring throughout drug therapy.

摘要

阿维 A 酯是一种合成的第二代维 A 酸类药物,主要用于治疗大疱性先天性鱼鳞病样红皮病(DD)。它通过与甾体/甲状腺受体超家族的核受体结合,从而改变基因表达,影响生物过程。本报告介绍了一例 41 岁男性患者,临床诊断为 DD,无其他共存合并症,在使用阿维 A 酯治疗后发生了甲状腺功能减退,这是该药物一种不常见且罕见的副作用。在开始使用阿维 A 酯之前,他的基线常规检查在正常范围内。阿维 A 酯诱导的甲状腺功能减退症用甲状腺素治疗。尽管阿维 A 酯有良好的治疗反应,但由于出现了副作用而无法继续使用,只能继续进行局部治疗。该病例强调了在无既往病史的患者中,治疗剂量的阿维 A 酯可能会产生不良反应,提示在整个药物治疗过程中进行持续的血液监测至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86d6/11286097/251cf9f7301c/IJPharm-56-220-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86d6/11286097/651ad86e033f/IJPharm-56-220-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86d6/11286097/251cf9f7301c/IJPharm-56-220-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86d6/11286097/651ad86e033f/IJPharm-56-220-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86d6/11286097/251cf9f7301c/IJPharm-56-220-g002.jpg

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本文引用的文献

1
Treatment of Darier disease with oral alitretinoin.口服阿利维 A 酸治疗大疱性表皮松解症。
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Dyskeratosis follicularis disease: case reports and review of the literature.毛囊角化病:病例报告及文献综述
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Darier's disease: epidemiology, pathophysiology, and management.毛囊角化病:流行病学、病理生理学及治疗
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Management of Darier's disease.毛囊角化病的管理
Clin Exp Dermatol. 1999 Mar;24(2):53-6. doi: 10.1046/j.1365-2230.1999.00416.x.