[Causal association between isotretinoin and inflammatory bowel disease: a case report]

Roaccutane[R] [isotretinoin] is used for the treatment of severe forms of acne resistant to adequate standard therapy. Inflammatory bowel disease [IBD] is described as a possible adverse drug reaction in the product information of isotretinoin. In a case study, we report the case of a 30 year old woman with a history of bloody diarrhea, abdominal pain and severe folliculitis/acne which had been treated with isotretinoin. Her clinical features worsened whilst on isotretinoin. Colonoscopy demonstrated diffuse ulcerative pancolitis. Isotretinoin treatment was discontinued and the patient was prescribed 5-aminosalicylic acid and corticosteroids. After a few months, steroids were discontinued and the patient went into clinical and laboratory remission. Evaluation of the possible causal association between isotretinoin treatment and IBD suggested a probable relationship, which should lead to considerable caution while prescribing this drug

Drug induced liver injury: a review article

The incidence of drug induced liver injury [DILI] is about 1/1000 to 1/10000 among patients who receive therapeutic drug doses. Drug induced hepatotoxicity is a major cause of acute and chronic liver disease. The severity of liver damage ranges from nonspecific changes in liver structure to acute liver failure, cirrhosis and liver cancer. Some common agents that can cause liver injury are acetaminophen, antibiotics, statins, INH and herbal drugs. Drug-induced hepatotoxicity can be categorized based on the pattern of liver enzyme alteration [hepatocellular, cholestatic or mixed pattern], the mechanism of hepatotoxicity [direct, immune mediated or idiosyncratic] and hjstologic findings on liver biopsy [steatosis or sinusoidal obstruction syndrome]. Treatment options for DILI include discontinuing the drug, conservative measurements and liver transplantation in the case of non-acetaminophen induced hepatotoxicity

Lipoid proteinosis: a case report urbach and wiethe disease

Lipoid proteinosis [LP] is a rare autosomal recessive disease characterized by the deposition of an amorphous hyaline material in the skin, mucosa and viscera. The classic manifestation is onset in infancy with a hoarse cry due to laryngeal infiltration. Skin and mucous changes develope, and the disease follows a slowly progressive course. In this case report, a 49 year-old man presented with a longstanding hoarseness since childhood, dysphagia and asymptomatic skin lesions. Esophageal biopsy showed the deposition of homogenous eosinophilic hyaline-like material compatible with LP