Minocycline-induced lupus: clinical features and response to rechallenge.
OBJECTIVE
To describe the spectrum of clinical features in patients with minocycline-induced lupus (MIL) and determine their response to rechallenge.


METHODS
The clinical features and laboratory findings of 23 patients with MIL were recorded. Ten patients were rechallenged, and their C-reactive protein (CRP) levels were monitored.


RESULTS
All subjects complained of polyarthralgia; three had metacarpophalangeal and proximal interphalangeal joint synovitis and one had bilateral knee effusions. Elevated hepatic transaminases were noted in eight subjects. Cutaneous vasculitis was a feature in two cases. None had renal or central nervous system disease, although five patients complained of impaired concentration and poor memory and a single patient had a peripheral sensory neuropathy. The following serological abnormalities were detected: antinuclear antibodies (19/23 patients); antibodies to double-stranded DNA (4/23); perinuclear antineutrophil cytoplasmic antibodies (10/15); IgG anti-cardiolipin antibodies (6/23); hypergammaglobulinaemia (12/19). Anti-histone antibodies were negative in 9/9 cases. Rechallenge resulted in rapid recurrence of symptoms and elevation of CRP levels.


CONCLUSIONS
MIL is associated with a wide spectrum of clinical and serological features. The diagnosis can be confirmed by rechallenge, which results in rapid reappearance of symptoms and a rise in CRP.
Lawson
T M
TM
Department of Rheumatology, University Hospital of Wales, Cardiff CF14 4XN, UK.
Amos
N
N
Bulgen
D
D
Williams
B D
BD
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000139:chemically induced* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D008911:Minocycline / Q000008:administration & dosage / Q000009:adverse effects*; D012008:Recurrence
D000900:Anti-Bacterial Agents; D008911:Minocycline