Isotretinoin exposure and risk of celiac disease

Shadi Rashtak, Shahryar Khaleghi, Eric V. Marietta, Mark R. Pittelkow, Joseph J. Larson, Brian D. Lahr, Joseph A. Murray

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Background: Isotretinoin (13-cis retinoic acid) is a metabolite of vitamin A and has anti-inflammatory and immunoregulatory effects; however, a recent publication by DePaolo et al. demonstrated that in the presence of IL-15, retinoic acid can act as an adjuvant and promote inflammation against dietary proteins. Objective: To evaluate the risk of overt and latent celiac disease (CD) among users of isotretinoin. Material and Methods: Medical records of patients from 1995 to 2011 who had a mention of isotretinoin in their records (N = 8393) were searched for CD diagnosis using ICD-09CM codes. Isotretinoin exposure was compared across overt CD patients and their age- and gender-matched controls from the same pool. To evaluate the risk of latent CD with isotretinoin exposure, patients were overlapped with a community-based list of patients with waste serum samples that were tested for CD serology, excluding those with overt CD (2006-2011). Isotretinoin exposure was defined as the use of isotretinoin prior to CD diagnosis or serology. Results: Of 8393 patients, 25 had a confirmed CD diagnosis. Compared to matched controls (N = 75), isotretinoin exposure was not significantly different between overt CD patients versus controls (36% versus 39%, respectively; P = 0.712). Likewise, latent CD defined as positive serology was not statistically different between isotretinoin exposed (N = 506) versus nonexposed (N = 571) groups (1.8% versus 1.4%, respectively; P = 0.474). Conclusions: There was no association between isotretinoin use and risk of either overt or latent CD.

Original languageEnglish (US)
Article numbere0135881
JournalPloS one
Issue number8
StatePublished - Aug 19 2015

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General


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