Isotretinoin is a synthetic retinoid used for the treatment of moderate to severe acne rosacea. Although various adverse effects during isotretinoin treatment have been reported, renal impairment is very rare. Herein we report a case of full-blown nephotic syndrome associated with isotretinoin treatment. A previously healthy 29 year old lady, presented with periorbital and ankle oedeme. Based on the clinical and laboratory findings , she was diagnosed as nephrotic syndrome. A renal biopsy was taken and minimal change disease was diagnosed due to electromicroscopic examination which showed prominent effacement and microvillus formation in the pedicels of epithelial cells in the glomerulus. The only significant point in the history was the use of isotretinoin (40 mgr/day) which had been prescribed six months ago for acne rosacea. Isotretinoin was immediately stopped and she was treated with 1 mg/kg/day alfa-methyl prednisolone. The nephrotic syndrome responded to treatment in 3 weeks. Nephrotic syndrome is a rare side effect of isotretinoin therapy and should be suspected in any patient with oedema formation during therapy.

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