Minocycline induced arthritis associated with fever, livedo reticularis, and pANCA.
OBJECTIVE
To describe a novel iatrogenic immunological reaction produced by minocycline.


METHODS
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.
Elkayam
O
O
Department of Rheumatology, Ichilov Hospital, Tel Aviv, Israel.
Yaron
M
M
Caspi
D
D
D000152:Acne Vulgaris / Q000188:drug therapy / Q000276:immunology; D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood; D001168:Arthritis / Q000139:chemically induced* / Q000276:immunology; D001323:Autoantibodies / Q000097:blood; D015415:Biomarkers / Q000097:blood; D005260:Female; D005334:Fever / Q000139:chemically induced / Q000276:immunology; D006801:Humans; D008911:Minocycline / Q000009:adverse effects* / Q000627:therapeutic use; D009195:Peroxidase / Q000276:immunology; D017445:Skin Diseases, Vascular / Q000139:chemically induced / Q000276:immunology
D000900:Anti-Bacterial Agents; D019268:Antibodies, Antineutrophil Cytoplasmic; D001323:Autoantibodies; D015415:Biomarkers; D009195:Peroxidase; D008911:Minocycline