Klin Padiatr 2017; 229(03): 175-176
DOI: 10.1055/s-0043-103087
Short Communication
© Georg Thieme Verlag KG Stuttgart · New York

Growth Failure Caused by Premature Epiphyseal Closure in a Child Treated with Isotretinoin for Neuroblastoma

Kleinwuchs durch vorzeitigen Epiphysenfugenschluss nach Retinsäuretherapie bei Neuroblastom bei einem Mädchen
Sophia Hoemberg
1   Pediatrics, Asklepios Kinderklinik Sankt Augustin, Sankt Augustin
,
Harald Reinhard
1   Pediatrics, Asklepios Kinderklinik Sankt Augustin, Sankt Augustin
› Author Affiliations
Further Information

Publication History

Publication Date:
30 May 2017 (online)

Introduction

Retinoids have demonstrated efficacy in a wide range of disorders. Children commonly receive vitamin A and its derivates to treat acne, ichthyotic skin disease and psoriasis. Furthermore retinoids are used in the treatment of neuroblastoma, hereby much higher dosages are administered than for dermatological diseases.

However, the beneficial effects of the drug on the one hand are limited on the other hand by its side effects such as hypercalcemia (Villablanca et al., Am J Pediatr Hematol Oncol1993; 15: 410–415) and premature epiphyseal closure (DiGiovanna; Am Acad Dermatol. 2001; 45: 176–182; Montag et al.; Radiologe 1988; 28: 320–325).

Vitamin A toxicity in children was recognized in the 1940s, when dietary overdosage was more prevalent than today (Caffey; Pediatrics 1950; 5: 672–688).

Today, most cases of vitamin A induced premature epiphyseal closure occur in pediatric dermatological patients after treatment with vitamin A analogues. In dermatological literature, such incidents are mainly reported about children and adolescents who received vitamin A and its derivates to treat acne, ichthyotic skin disease and psoriasis.

In neuroblastoma patients, retinoids are used as differentiation inducing compounds in the antineoplastic treatment in certain subgroups. According to the current German NB2004 Trial Protocol (NCT 00410631) children of medium and high risk groups receive an aggressive multimodal therapy including isotretinoin (13-cis-retinoic acid).