Minocycline-induced lupus. A systematic review.
BACKGROUND
Minocycline has increasingly been associated with different adverse auto-immune reactions including drug-induced lupus.


OBJECTIVE
To identify the scope of minocycline-induced lupus and to characterise its typical features.


METHODS
Comprehensive Medline and Embase search of the English and non-English literature for case reports of minocycline-induced lupus.


RESULTS
We included 57 cases of minocycline-induced lupus (mean age +/- SD at onset: 21.6+/-8.6 years, median time of exposure: 19 months, range 3 days to 6 years). All patients showed the clinical features of polyarthralgia/polyarthritis often accompanied by liver abnormalities. Twelve patients had evidence of dermatological manifestations (i.e rash, livedo reticularis, oral ulceration, subcutaneous nodules, alopecia). The ANA test was positive in all patients.


CONCLUSIONS
Long-term exposure to minocycline may be associated with drug-induced lupus. Baseline and periodic liver function and ANA tests accompanied by appropriate clinical monitoring are suggested for patients receiving long-term minocycline therapy.
Schlienger
R G
RG
Division of Clinical Pharmacology, University Hospital, Basel, Switzerland. rschlienger@uhbs.ch
Bircher
A J
AJ
Meier
C R
CR
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D000974:Antibodies, Antinuclear / Q000032:analysis; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000139:chemically induced / Q000276:immunology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D008911:Minocycline / Q000009:adverse effects*
D000900:Anti-Bacterial Agents; D000974:Antibodies, Antinuclear; D008911:Minocycline