A Rare Case of Isotretinoin Syndrome Unintentional Maternal Exposur

Abstract

Retinoids are synthetic analogs of vitamin A, they have a key role in cellular differentiation and developmental tissue specificity. Accutane (isotretinoin) is widely used to treat cases of cystic and conglobate acne resistant to other forms of therapy [1]. It has been estimated that 40% of pregnancies exposed to isotretinoin progress to spontaneous abortion and 35% develop embryopathy [2], either conotruncal heart defects (tetralogy of Fallot, transposition of the great arteries ...), Central nervous system malformations (hydrocephalus, agenesis of the vermis, hypoplasia of the cerebellum ...), ear defects (anotia, microtia, aplasia of the external auditory canal ...), as well as thymic malformations (aplasia, ectopia, hypoplasia). The risk period mainly concerns the first two months of pregnancy [3]. The present case is of an infant aged 2 months and 9 days with a history of prenatal exposure to isotretinoin, a now preventable clinical condition. He was born with a craniofacial malformation called dolichocephaly associated with bilateral micrognathia. Cardiological examinations revealed complex congenital heart disease with transposition of the great arteries, an anteriorly positioned aorta to the right of the pulmonary artery, and a 10-mm subpulmonary septal defect. Aside from his dysmorphic syndrome, his outcome was unfavorable.