minocycline and Arthralgia

Topics: Arthralgia; Erythema; Female; Fever; Humans; Lower Extremity; Middle Aged; Minocycline; Polyarteritis Nodosa

Because minocycline can cause serious adverse events including hypersensitivity syndrome reaction (HSR), serum sicknesslike reaction (SSLR), and drug-induced lupus, a follow-up study based on a retrospective review of our Drug Safety Clinic and the Health Protection Branch databases and a literature review was conducted to determine if similar rare events are associated with tetracycline and doxycycline. Cases of isolated single organ dysfunction (SOD) attributable to the use of these antibiotics also were identified.. Nineteen cases of HSR due to minocycline, 2 due to tetracycline, and 1 due to doxycycline were identified. Eleven cases of SSLR due to minocycline, 3 due to tetracycline, and 2 due to doxycycline were identified. All 33 cases of drug-induced lupus were attributable to minocycline. Forty cases of SOD from minocycline, 37 cases from tetracycline, and 6 from doxycycline were detected. Hypersensitivity syndrome reaction, SSLR, and SOD occur on average within 4 weeks of therapy, whereas minocycline-induced lupus occurs on average 2 years after the initiation of therapy.. Early serious events occurring during the course of tetracycline antibiotic treatment include HSR, SSLR, and SOD. Drug-induced lupus, which occurs late in the course of therapy, is reported only with minocycline. We theorize that minocycline metabolism may account for the increased frequency of serious adverse events with this drug.

Topics: Adolescent; Adult; Adverse Drug Reaction Reporting Systems; Anti-Bacterial Agents; Arthralgia; Canada; Databases as Topic; Doxycycline; Drug Eruptions; Drug Hypersensitivity; Drug Prescriptions; Female; Fever; Follow-Up Studies; Humans; Liver; Lupus Erythematosus, Systemic; Male; Middle Aged; Minocycline; Retrospective Studies; Safety; Serum Sickness; Syndrome; Tetracycline; Time Factors

In addition to tetracyclines, zinc may constitute an alternative treatment in inflammatory lesions of acne.. To evaluate the place of zinc gluconate in relation to antibiotics in the treatment of acne vulgaris.. Zinc was compared to minocycline in a multicenter randomized double-blind trial. 332 patients received either 30 mg elemental zinc or 100 mg minocycline over 3 months. The primary endpoint was defined as the percentage of the clinical success rate on day 90 (i.e. more than 2/3 decrease in inflammatory lesions, i.e. papules and pustules).. This clinical success rate was 31.2% for zinc and 63.4% for minocycline. Minocycline nevertheless showed a 9% superiority in action at 1 month and one of 17% at 3 months, with respect to the mean change in lesion count. Regarding safety, the majority of the adverse effects of zinc gluconate and of minocycline concerned the gastrointestinal system and were moderate (5 dropouts with zinc gluconate and 4 with minocycline).. Minocycline and zinc gluconate are both effective in the treatment of inflammatory acne, but minocycline has a superior effect evaluated to be 17% in our study.

Topics: Abdominal Pain; Acne Vulgaris; Adolescent; Adult; Anti-Bacterial Agents; Arthralgia; Dermatitis, Seborrheic; Double-Blind Method; Female; Gluconates; Humans; Hypersensitivity; Male; Minocycline; Nausea; Patient Compliance; Patient Dropouts; Patient Satisfaction; Skin; Treatment Outcome; Urticaria; Vomiting; Zinc

We report a case of serum sickness-like reaction (SSLR) in a 14-year-old male taking minocycline for acne. The patient presented with urticarial rash, arthralgia/arthritis, and tender lymphadenopathy. Symptoms resolved with discontinuation of minocycline and treatment with prednisone, cetirizine, and ibuprofen. SSLR is a rare complication of minocycline treatment that may go unrecognized and underreported.

Topics: Acne Vulgaris; Adolescent; Anti-Bacterial Agents; Arthralgia; Humans; Male; Minocycline; Serum Sickness

To investigate nociceptive behavior and the immunoreactivity of microglia and phosphorylated-p38 (p-p38) mitogen-activated protein kinase (MAPK) following intracisternal administration of SB203580, a p38 MAPK inhibitor, or minocycline, a microglia inhibitor, in rats with temporomandibular joint (TMJ) inflammation.. The number of nociceptive behavioral responses was recorded for nine successive 5-minute intervals following formalin injections into the left TMJ. SB203580 or minocycline was administered intracisternally 2 hours prior to the formalin injection. Statistical analysis used one-way analysis of variance followed by least significant difference post-hoc analysis.. The intra-articular injection of formalin increased the expression of p-p38 MAPK in the ipsilateral medullary dorsal horn. Most of the p-p38 MAPK co-localized with OX42, a microglial marker, but not with GFAP, an astrocyte marker. Intracisternal injections of SB203580 (0.5, 1, or 5 Μg) attenuated the number of nociceptive behavioral responses and the expression of p-p38 MAPK in the medullary dorsal horn. Intracisternal injections of minocycline (25 or 50 Μg) also attenuated the responses and the expression of OX42 and p-p38 MAPK in the medullary dorsal horn.. These findings suggest that p38 MAPK in microglia plays an important role in the central processing of inflammatory TMJ nociception in rats. The data further indicate that a targeted blockade of the microglial p38 MAPK pathway is a potentially important new treatment strategy for inflammatory TMJ nociception.

Topics: Analysis of Variance; Animals; Arthralgia; Cisterna Magna; Endpoint Determination; Formaldehyde; Imidazoles; Injections, Intra-Articular; Male; Microglia; Minocycline; Motor Activity; Nociception; p38 Mitogen-Activated Protein Kinases; Phosphorylation; Posterior Horn Cells; Protease Inhibitors; Pyridines; Rats; Rats, Sprague-Dawley; Temporomandibular Joint; Temporomandibular Joint Disorders

A 47-year-old man who had been taking minocycline for palmoplantar pustulosis developed fever, myalgias, polyneuropathy, and testicular pain, with elevated C-reactive protein (CRP). Neither myeloperoxidase- nor proteinase-3-antineutrophil cytoplasmic antibody was positive. These manifestations met the American College of Rheumatology 1990 criteria for the classification of polyarteritis nodosa. Stopping minocycline led to amelioration of symptoms and normalization of CRP level. To our knowledge, this is the second case of minocycline-induced vasculitis satisfying the criteria. Differential diagnosis for drug-induced disease is invaluable even for patients with classical polyarteritis nodosa.

Topics: Anti-Bacterial Agents; Arthralgia; C-Reactive Protein; Humans; Male; Middle Aged; Minocycline; Paresthesia; Polyarteritis Nodosa; Psoriasis; Testis

Alkaptonuria, a rare autosomal-recessive disorder caused by mutations in the HGD gene and a deficiency of homogentisate 1,2-dioxygenase, is characterized by accumulation of homogentisic acid (HGA), ochronosis, and destruction of connective tissue resulting in joint disease. Certain medications have been reported to cause cutaneous hyperpigmentation resembling that of alkaptonuria. We present 5 such cases. Eighty-eight patients with a possible diagnosis of alkaptonuria were examined at the National Institutes of Health Clinical Center between June 2000 and March 2004. The diagnosis of alkaptonuria was confirmed or ruled out by measurement of HGA in the urine. Five patients with findings consistent with ochronosis, including pigmentary changes of the ear and mild degenerative disease of the spine and large joints, were diagnosed clinically as having alkaptonuria, but the diagnosis was withdrawn based on normal urine HGA levels. All 5 patients were women who had taken minocycline for dermatologic or rheumatologic disorders for extended periods. Minocycline-induced hyperpigmentation should be considered in the differential diagnosis of ochronosis. This could be of increased significance now that minocycline and other tetracyclines have been proposed as therapeutic options for rheumatoid arthritis, bringing a new population of patients with ochronosis and arthritis to medical attention with the potential, but incorrect, diagnosis of alkaptonuria.

Topics: Abscess; Acne Vulgaris; Adult; Aged; Alkaptonuria; Arthralgia; Arthritis, Rheumatoid; Diagnosis, Differential; Facial Dermatoses; Female; Humans; Hyperpigmentation; Middle Aged; Minocycline; Radiography

Minocycline is an oral antibiotic widely used for the long-term treatment of acne and rheumatoid arthritis. A few patients develop antineutrophil cytoplasmic antibodies (ANCAs) during minocycline therapy. In this report, the authors describe a case of severe pauci-immune crescentic and necrotizing glomerulonephritis associated with positive cytoplasmic ANCA (C-ANCA) titers and proteinase 3 (PR3) levels after minocycline therapy. Discontinuation of minocycline and initiation of immunosuppressive treatment resulted in improvement of renal function and decline in C-ANCA titers and PR3 levels. A high degree of suspicion, testing for ANCA titers, prompt discontinuation of the drug, and initiation of immunosuppressive treatment are crucial to the diagnosis and treatment of drug-induced ANCA-associated glomerulonephritis.

Topics: Adult; Animals; Antibodies, Antineutrophil Cytoplasmic; Arthralgia; Arthritis, Rheumatoid; Autoimmune Diseases; Bites and Stings; Diagnostic Errors; Female; Glomerulonephritis; Humans; Immunosuppressive Agents; Minocycline; Myeloblastin; Serine Endopeptidases; Ticks

Topics: Acne Vulgaris; Adolescent; Adult; Anti-Bacterial Agents; Arthralgia; Arthritis; Case-Control Studies; Cohort Studies; Drug Eruptions; Female; Humans; Lupus Erythematosus, Systemic; Male; Minocycline; Odds Ratio

Search for etiology in young subjects with joint disease must take into consideration causes other than reactional arthropathy or systemic disease.. Two young subjects consulted for joint pain involving various joints. Physical examination did not reveal any other abnormality. Serum tests were positive for antinuclear antibodies and/or showed moderately and persistently elevated transaminases. History taking revealed that these subjects had been taking minocyclin chlorhydrate for several months, or even years, for acne. Joint pain subsided with drug withdrawal and serum tests returned to normal.. Long-term treatment with minocylin chlorhydrate should always be included in the search for an etiology in patients presenting joint pain.

Topics: Adolescent; Adult; Age Factors; Antibodies, Antinuclear; Arthralgia; Dose-Response Relationship, Drug; Female; Humans; Joints; Minocycline; Transaminases

Topics: Anti-Bacterial Agents; Arthralgia; Hepatitis, Autoimmune; Humans; Minocycline; Pleurodynia, Epidemic

Prolonged treatment with minocycline for acne vulgaris has been associated with the development of arthralgia, arthritis, and other autoimmune phenomena. We characterized the clinical, laboratory, and immunological profiles of seven patients with this syndrome.. Clinically the patients were studied with special emphasis on prior minocycline treatment, presenting symptoms, physical findings, course, and outcome. Laboratory tests included fluorescent antinuclear and antineutrophil cytoplasmic (ANCA) antibodies, as well as antibodies to myeloperoxidase, bactericidal permeability increasing protein, elastase, cathepsin G, lactoferrin, cardiolipin, and histone.. All 7 patients presented with polyarthritis or arthralgia, morning stiffness, and fever after 6 to 36 months of minocycline treatment. The skin was involved in five patients (three with livedo reticularis and two with subcutaneous nodules). Two patients had chronic active hepatitis. Increased titers of perinuclear ANCA (p-ANCA) were detected in all seven patients; five patients had fluorescent antinuclear antibodies, two had antihistone autoantibodies and one had anticardiolipin antibodies. Antigenic characterization of p-ANCA disclosed antibodies to bactericidal permeability increasing protein in one patient, to elastase in three patients, and to cathepsin G in five patients. Symptoms resolved in five patients upon discontinuation of minocycline; the other two patients were treated with corticosteroids and also achieved remissions.. Minocycline-induced autoimmune syndrome is characterized by reversible polyarthralgia or arthritis, morning stiffness, fever, frequent skin involvement, occasional chronic active hepatitis, and increased titers of p-ANCA with various minor p-ANCA-related antigens.

Topics: Acne Vulgaris; Adult; Anti-Bacterial Agents; Antibodies, Anticardiolipin; Antibodies, Antineutrophil Cytoplasmic; Arthralgia; Arthritis; Autoantibodies; Autoimmune Diseases; C-Reactive Protein; Female; Humans; Male; Minocycline