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Minocycline-induced renal polyarteritis nodosa
Hossein Tabriziani1, Christopher S Wilcox, Olivia N Gilbert
1Division of Nephrology and Hypertension, Georgetown University, Washington, DC, USA.
BMJ Case Reports
|August 15, 2012
Summary
Minocycline, an acne medication, may trigger polyarteritis nodosa (PAN), a rare autoimmune condition. This case report details a patient who developed renal PAN after prolonged minocycline use, highlighting a potential drug-induced vasculitis.
Area of Science:
- Rheumatology
- Dermatology
- Pharmacology
Background:
- Minocycline, a tetracycline antibiotic, is widely used for acne treatment.
- While generally safe, minocycline has been linked to various adverse effects, including autoimmune phenomena.
- Polyarteritis nodosa (PAN) is a systemic vasculitis affecting medium-sized arteries.
Observation:
- A 21-year-old woman presented with fatigue, myalgias, weight loss, and severe headaches.
- Her medical history included long-term minocycline use for acne and oral contraceptive use.
- Clinical presentation revealed tachycardia, severe hypertension, hyponatremia, hypokalemia, and elevated inflammatory markers.
Findings:
- Autoimmune work-up was positive for perinuclear antineutrophil cytoplasmic antibodies.
- Renal arteriogram confirmed findings consistent with polyarteritis nodosa (PAN).
- The patient met the American College of Rheumatology criteria for PAN diagnosis.
Implications:
- This case suggests minocycline as a potential trigger for renal polyarteritis nodosa (PAN).
- Discontinuation of minocycline and initiation of immunosuppressive therapy (cyclophosphamide, prednisone) led to symptom improvement.
- This report underscores the importance of considering drug-induced vasculitis in patients presenting with symptoms of PAN.
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