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Minocycline-induced polyarteritis nodosa-like vasculitis presenting as brainstem stroke
James P Klaas1, Thomas Matzke2, Ashima Makol3
1Department of Neurology, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, USA.
Summary
Minocycline can cause drug-induced vasculitis, a rare condition that may lead to ischemic stroke, even in young individuals. Promptly discontinuing minocycline can resolve vasculitis and prevent further neurological events.
Area of Science:
- Rheumatology
- Neurology
- Dermatology
Background:
- Minocycline, a commonly prescribed antibiotic, is known to be associated with autoimmune disorders.
- Drug-induced vasculitis is a recognized adverse effect, typically presenting with cutaneous, constitutional, or musculoskeletal symptoms.
Observation:
- A 26-year-old woman without vascular risk factors developed an ischemic pontine stroke.
- The stroke occurred in the context of biopsy-proven polyarteritis nodosa-like vasculitis attributed to minocycline use.
Findings:
- This case highlights that minocycline-induced vasculitis can manifest as ischemic stroke, a presentation not commonly reported.
- Discontinuation of minocycline led to the resolution of vasculitis and no recurrence of ischemic events.
Implications:
- Physicians should consider drug-induced vasculitis as a potential cause of ischemic stroke in patients using minocycline.
- Early recognition and withdrawal of minocycline are crucial to prevent severe neurological complications, particularly in younger populations.
