Minocycline-related lupus

Five cases of suspected drug-related lupus are described in young female patients who had been taking minocycline for several years. All were asymptomatic before starting treatment. After variable but prolonged periods of continuous therapy all abruptly developed arthralgia/arthritis and on testing were antinuclear factor positive. In four cases the symptoms and signs disappeared within a short time of stopping the drug, whereas in the remaining case the systemic nature of the illness required treatment with corticosteroids. Three patients who were rechallenged with minocycline quickly developed a recurrence of their joint symptoms. Resolution of the serological abnormalities noted in these patients occurred more slowly than the resolution of the clinical symptoms. We propose a direct relationship in these cases between minocycline therapy and the occurrence of a lupus-like syndrome.