title: Minocycline-induced polyarteritis nodosa-like vasculitis presenting as brainstem stroke.
abstract: Minocycline use has been associated with the development of autoimmune disorders, including drug-induced vasculitis. Previously published reports suggest that clinical manifestations are limited to cutaneous, constitutional, or musculoskeletal symptoms. To our knowledge there has been only one reported patient with ischemic stroke in the setting of minocycline-induced vasculitis. We describe a 26-year-old woman, with no vascular risk factors, who had an ischemic pontine stroke in the setting of biopsy-proven minocycline-induced polyarteritis nodosa-like vasculitis. Discontinuation of minocycline resulted in resolution of the vasculitis, and she has not had any recurrent ischemic events. This report shows that ischemic strokes may occur as a result of minocycline-induced vasculitis. While this is likely a rare association, recognition is important given the widespread use of minocycline and the potential for devastating consequences in a young population. Consequently, drug-induced vasculitis should be considered in patients with an ischemic stroke taking minocycline.
authors.affiliation: Department of Neurology, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, USA. Electronic address: klaas.james@mayo.edu.
authors.forename: James P
authors.initials: JP
authors.lastname: Klaas
authors.affiliation: Department of Dermatology, Sanford Health, Fargo, ND, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Matzke
authors.affiliation: Department of Rheumatology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Ashima
authors.initials: A
authors.lastname: Makol
authors.affiliation: Department of Neurology, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, USA.
authors.forename: Jimmy R
authors.initials: JR
authors.lastname: Fulgham
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D020526:Brain Stem Infarctions / Q000139:chemically induced* / Q000175:diagnosis; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008911:Minocycline / Q000009:adverse effects*; D010488:Polyarteritis Nodosa / Q000139:chemically induced* / Q000175:diagnosis; D020293:Vasculitis, Central Nervous System / Q000139:chemically induced* / Q000175:diagnosis
chemical_list: D000900:Anti-Bacterial Agents; D008911:Minocycline
keywords: Minocycline; Pharmacology; Polyarteritis nodosa; Stroke; Vasculitis