ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1569

Isotretinoin Induced Seronegative Spondyloarthropathy: Magnetic Resonance Imaging As Diagnostic and Prognostic Biomarker

Basant Elnady1,2, Dalia Desouky3,4, Tohamy Elkhouly5,6, Noha Dawoud7,8 and Hanady Kewan9,10, 1Assistant professor of rheumatology and rehabilitation, department of rheumatology and rehabilitation ، faculty of medicine, Benha university, Benha, Egypt, 2Rheumatology consultant ,Rheumatology division ,Al Hada Armed Forcec Hospital, Taif, Saudi Arabia, 3Assistant professor of public health  and community medicine,department of public health and community medicine,Faculty of medicine, menoufia University, menoufia, Egypt, 4Assistant professor of public health and community medicine, department of family and community medicine، faculty of medicine, taif university, Taif, Saudi Arabia, 5Assistant professor of radiology, radiology department ، faculty of medicine, Benha university, Benha, Egypt, 6Radiology consultant , Department of radiology ,Alhada Armed Forces Hospital, Taif, Saudi Arabia, 7department of dermatology , andrology, and STDs, faculty of medicine, Menoufia university, menoufia, Egypt, 8department of dermatology, Alhada armed forces hospital, Tafi, Ksa, taif, Saudi Arabia, 9Department of radio-diagnosis, Faculty of medicine, Mansoura University., Mansoura, Egypt, 10Radiology consultant ,Department of radiology, Al Hada Armed Forces Hopital, taif, Saudi Arabia

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords:

Session Information

Date: Monday, November 6, 2017

Title: Spondyloarthropathies and Psoriatic Arthritis – Pathogenesis, Etiology Poster II

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose:

Recent data has revealed occurrence of musculoskeletal manifestations in particular sacroiliitis and inflammatory back pain (IBP) secondary to isotretinoin therapy for acne valgaris, accordingly our study conducted to detect the prevalence of isotretinoin triggered rheumatic side-effects, with close clinical and radiological follow up to assess the drug impact on musculoskeletal system.

Methods:

513 acne patients on isotretinoin therapy were enrolled from dermatology out patients’ clinic, screened for musculoskeletal manifestations related features resulting from isotretinoin therapy, all patients were HLA B27 negative. At baseline C-reactive protein (CRP), Magnetic resonance imaging (MRI) sacroiliac joint, onset of IBP and pain score were reported. MRI proven sacroiliitis, has been scored with semi-quantitative score. Clinical and radiological follow up of our patients were done, patients who met ASAS classification criteria for spondyloarthropathy (SpA) were assessed for disease activity by Ankylosing Spondylitis Disease Activity Score (ASDAS) (3). MRI for sacroiliac joints and CRP were repeated three weeks after being symptomless, with isotretinoin discontinuation.

Results:

513 acne patients were enrolled, 123 (23.9%) developed IBP, and 88 (17.1%) developed arthralgia and arthritis .The mean onset of IBP was (2.1±0.85) months, with mean baseline pain score of (4.34±3.09). MRI proven sacroiliitis was found in (0.13%) of total number of acne patients, and (42.27%) of symptomatic patients, baseline CRP was (32.05±17.23 mg/L) and (3.4±2.7 mg/L) after being symptomless. 51.9% of the symptomatic patients had fulfilled the ASAS criteria for axial SpA, 97.6% of patients were treated with NSAID, however 2.4% were treated with anti TNF biologic. all cases normalized within 9 months, the mean time of normalization was (6.27±1.7) months. There was significant positive correlation for MRI scores, with pain, ASAS scores, baseline CRP. Unilateral sacroiliitis patients had significant rapid improvement than bilateral sacroiliitis (P<0.05).

Conclusion: Isotretinoin induced SpA is quite common side effect .Early rheumatologic assessment, and intervention is recommended. MRI is the modality of choice in early detection, and follow up of isotretinoin induced sacroiliitis.


Disclosure: B. Elnady, None; D. Desouky, None; T. Elkhouly, None; N. Dawoud, None; H. Kewan, None.

To cite this abstract in AMA style:

Elnady B, Desouky D, Elkhouly T, Dawoud N, Kewan H. Isotretinoin Induced Seronegative Spondyloarthropathy: Magnetic Resonance Imaging As Diagnostic and Prognostic Biomarker [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/isotretinoin-induced-seronegative-spondyloarthropathy-magnetic-resonance-imaging-as-diagnostic-and-prognostic-biomarker/. Accessed .

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