An unusual adverse drug reaction?
BACKGROUND
Adult Still Disease (ASD) is a rare (incidence 1-1,6/1,000,000 in Europe) seronegative polyarthropathy diagnosed with clinical criteria, excluding other etiologies. Minocycline, a semisynthetic derivative of tetracycline, has been associated with many adverse effects. We present the case of a 18-years-old man with a high suspicion of an adverse drug reaction (ADR), that was finally diagnosed of ASD.


METHODS
In order to exclude other diseases, laboratory test, radiology and allergological studies were performed. The results of the allergological studies excluded the possibility of an ADR. The rest of the results determined the diagnosis of ASD.


CONCLUSIONS
It's necessary to emphasize the importance of an accurate differential diagnosis in cases like this, because many diseases may mimic an ADR, and may be underdiagnosed (or misdiagnosed).
Montoro
J
J
Allergy Unit, Internal Medicine Service, Spain. montoro_fra@gua.es
Freixenet
N
N
Lozano
A
A
Bertomeu
F
F
D000293:Adolescent; D001168:Arthritis / Q000209:etiology*; D002744:Chlorpheniramine / Q000627:therapeutic use; D003131:Combined Modality Therapy; D017985:Dalteparin / Q000627:therapeutic use; D003951:Diagnostic Errors; D003875:Drug Eruptions / Q000175:diagnosis*; D004417:Dyspnea / Q000209:etiology; D004431:Ear, External; D004814:Epidermal Cyst / Q000150:complications; D005440:Fluid Therapy; D006801:Humans; D034141:Hypoalbuminemia / Q000209:etiology; D007213:Indomethacin / Q000627:therapeutic use; D008206:Lymphatic Diseases / Q000209:etiology; D008297:Male; D008911:Minocycline / Q000009:adverse effects* / Q000627:therapeutic use; D009853:Omeprazole / Q000627:therapeutic use; D010493:Pericarditis / Q000209:etiology; D010612:Pharyngitis / Q000209:etiology; D011241:Prednisone / Q000627:therapeutic use; D011507:Proteinuria / Q000209:etiology; D012874:Skin Diseases, Infectious / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D016706:Still's Disease, Adult-Onset / Q000097:blood / Q000175:diagnosis* / Q000209:etiology / Q000652:urine
C018904:dexchlorpheniramine; D002744:Chlorpheniramine; D008911:Minocycline; D009853:Omeprazole; D017985:Dalteparin; D011241:Prednisone; D007213:Indomethacin