Isotretinoin-Associated Serum Creatinine Elevation During Acne Treatment: A Case Report.

BACKGROUND: Isotretinoin is first-line for moderate-to-severe acne. Its common adverse reactions involve the mucocutaneous system, liver, and lipid metabolism, while renal dysfunction is often overlooked with scarce reports. CASE PRESENTATION: A 34-year-old female without prior renal dysfunction received isotretinoin 20 mg/day for acne. Serum creatinine rose after 3 weeks, reached 82.6 μmol/L by week 5, then decreased stepwise after discontinuation and normalized on follow-up. Urinary ultrasound was unremarkable. OBSERVATIONS AND ANALYSIS: The Naranjo score was 7, indicating a probable association. Unlike previous renal adverse events presenting with dysuria, edema, flank pain, or hematuria, this case was asymptomatic, which may be attributed to individual differences in drug metabolism. CONCLUSION: This case report describes a mild elevation in serum creatinine that was possibly associated with isotretinoin therapy and highlights the importance of clinical awareness of potential renal function changes during treatment, particularly in patients receiving long-term therapy or concomitant medications.