Skip to main content
PMC home page
Annals of the Rheumatic Diseases logoLink to Annals of the Rheumatic Diseases
. 1996 Oct;55(10):769–771. doi: 10.1136/ard.55.10.769

Minocycline induced arthritis associated with fever, livedo reticularis, and pANCA.

O Elkayam 1, M Yaron 1, D Caspi 1
PMCID: PMC1010297  PMID: 8984944

Abstract

OBJECTIVE: To describe a novel iatrogenic immunological reaction produced by minocycline. CASE REPORTS: The clinical course and laboratory results of three women who presented with similar rheumatological manifestations after a prolonged exposure to minocycline are described. All three presented a unique reaction manifested by fever, arthritis/arthralgia and livedo reticularis during treatment with minocycline for acne vulgaris. The clinical syndrome was associated with high titre of serum perinuclear anticytoplasmatic antibodies (p-ANCA) and antimyeloperoxidase antibody (anti-MPO). Symptoms resolved after stopping the drug and recurred promptly after rechallenge in all three patients. CONCLUSIONS: Minocycline, which is widely used in the treatment of acne, often without adequate supervision, may induce arthritis and livedo vasculitis associated with anti-MPO.

Full text

PDF
769

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Allen J. C. Minocycline. Ann Intern Med. 1976 Oct;85(4):482–487. doi: 10.7326/0003-4819-85-4-482. [DOI] [PubMed] [Google Scholar]
  2. Bridges A. J., Graziano F. M., Calhoun W., Reizner G. T. Hyperpigmentation, neutrophilic alveolitis, and erythema nodosum resulting from minocycline. J Am Acad Dermatol. 1990 May;22(5 Pt 2):959–962. doi: 10.1016/0190-9622(90)70135-5. [DOI] [PubMed] [Google Scholar]
  3. Byrne P. A., Williams B. D., Pritchard M. H. Minocycline-related lupus. Br J Rheumatol. 1994 Jul;33(7):674–676. doi: 10.1093/rheumatology/33.7.674. [DOI] [PubMed] [Google Scholar]
  4. Cambridge G., Wallace H., Bernstein R. M., Leaker B. Autoantibodies to myeloperoxidase in idiopathic and drug-induced systemic lupus erythematosus and vasculitis. Br J Rheumatol. 1994 Feb;33(2):109–114. doi: 10.1093/rheumatology/33.2.109. [DOI] [PubMed] [Google Scholar]
  5. D'Cruz D., Chesser A. M., Lightowler C., Comer M., Hurst M. J., Baker L. R., Raine A. E. Antineutrophil cytoplasmic antibody-positive crescentic glomerulonephritis associated with anti-thyroid drug treatment. Br J Rheumatol. 1995 Nov;34(11):1090–1091. doi: 10.1093/rheumatology/34.11.1090. [DOI] [PubMed] [Google Scholar]
  6. Dolman K. M., Gans R. O., Vervaat T. J., Zevenbergen G., Maingay D., Nikkels R. E., Donker A. J., von dem Borne A. E., Goldschmeding R. Vasculitis and antineutrophil cytoplasmic autoantibodies associated with propylthiouracil therapy. Lancet. 1993 Sep 11;342(8872):651–652. doi: 10.1016/0140-6736(93)91761-a. [DOI] [PubMed] [Google Scholar]
  7. Frost P., Weinstein G. D., Gomez E. C. Phototoxic potential of minocycline and doxycycline. Arch Dermatol. 1972 May;105(5):681–683. [PubMed] [Google Scholar]
  8. Gorard D. A. Late-onset drug fever associated with minocycline. Postgrad Med J. 1990 May;66(775):404–405. doi: 10.1136/pgmj.66.775.404. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Gough A., Chapman S., Wagstaff K., Emery P., Elias E. Minocycline induced autoimmune hepatitis and systemic lupus erythematosus-like syndrome. BMJ. 1996 Jan 20;312(7024):169–172. doi: 10.1136/bmj.312.7024.169. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Gross W. L., Schmitt W. H., Csernok E. ANCA and associated diseases: immunodiagnostic and pathogenetic aspects. Clin Exp Immunol. 1993 Jan;91(1):1–12. doi: 10.1111/j.1365-2249.1993.tb03345.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Hofstra A. H., Li-Muller S. M., Uetrecht J. P. Metabolism of isoniazid by activated leukocytes. Possible role in drug-induced lupus. Drug Metab Dispos. 1992 Mar-Apr;20(2):205–210. [PubMed] [Google Scholar]
  12. Jiang X., Khursigara G., Rubin R. L. Transformation of lupus-inducing drugs to cytotoxic products by activated neutrophils. Science. 1994 Nov 4;266(5186):810–813. doi: 10.1126/science.7973636. [DOI] [PubMed] [Google Scholar]
  13. Jones B. F., Major G. A. Crescentic glomerulonephritis in a patient taking penicillamine associated with antineutrophil cytoplasmic antibody. Clin Nephrol. 1992 Nov;38(5):293–293. [PubMed] [Google Scholar]
  14. Kallenberg C. G., Brouwer E., Weening J. J., Tervaert J. W. Anti-neutrophil cytoplasmic antibodies: current diagnostic and pathophysiological potential. Kidney Int. 1994 Jul;46(1):1–15. doi: 10.1038/ki.1994.239. [DOI] [PubMed] [Google Scholar]
  15. Nässberger L., Sjöholm A. G., Jonsson H., Sturfelt G., Akesson A. Autoantibodies against neutrophil cytoplasm components in systemic lupus erythematosus and in hydralazine-induced lupus. Clin Exp Immunol. 1990 Sep;81(3):380–383. doi: 10.1111/j.1365-2249.1990.tb05342.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Puyana J., Ureña V., Quirce S., Fernandez-Rivas M., Cuevas M., Fraj J. Serum sickness-like syndrome associated with minocycline therapy. Allergy. 1990 May;45(4):313–315. doi: 10.1111/j.1398-9995.1990.tb00502.x. [DOI] [PubMed] [Google Scholar]
  17. Ridgway H. A., Sonnex T. S., Kennedy C. T., Millard P. R., Henderson W. J., Gold S. C. Hyperpigmentation associated with oral minocycline. Br J Dermatol. 1982 Jul;107(1):95–102. doi: 10.1111/j.1365-2133.1982.tb00296.x. [DOI] [PubMed] [Google Scholar]
  18. Rossman R. E. Minocycline treatment of tetracycline-resistant and tetracycline-responsive acne vulgaris. Cutis. 1981 Feb;27(2):196-7, 201, 207. [PubMed] [Google Scholar]
  19. Singer S., Parry R. G., Deodhar H. A., Barnes J. N. Acute interstitial nephritis, omeprazole and antineutrophil cytoplasmic antibodies. Clin Nephrol. 1994 Oct;42(4):280–280. [PubMed] [Google Scholar]
  20. Sitbon O., Bidel N., Dussopt C., Azarian R., Braud M. L., Lebargy F., Fourme T., de Blay F., Piard F., Camus P. Minocycline pneumonitis and eosinophilia. A report on eight patients. Arch Intern Med. 1994 Jul 25;154(14):1633–1640. [PubMed] [Google Scholar]
  21. Wiik A. Granulocyte-specific antinuclear antibodies. Possible significance for the pathogenesis, clinical features and diagnosis of rheumatoid arthritis. Allergy. 1980 Jun;35(4):263–289. doi: 10.1111/j.1398-9995.1980.tb01768.x. [DOI] [PubMed] [Google Scholar]
  22. Wiik A., Stummann L., Kjeldsen L., Borregaard N., Ullman S., Jacobsen S., Halberg P. The diversity of perinuclear antineutrophil cytoplasmic antibodies (pANCA) antigens. Clin Exp Immunol. 1995 Jul;101 (Suppl 1):15–17. doi: 10.1111/j.1365-2249.1995.tb06155.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Yamamoto K., Kawanishi S. Free radical production and site-specific DNA damage induced by hydralazine in the presence of metal ions or peroxidase/hydrogen peroxide. 1991 Mar 15-Apr 1Biochem Pharmacol. 41(6-7):905–914. doi: 10.1016/0006-2952(91)90195-b. [DOI] [PubMed] [Google Scholar]

Articles from Annals of the Rheumatic Diseases are provided here courtesy of BMJ Publishing Group

RESOURCES