minocycline and Diplopia

Thyroid dysfunction in adolescents treated with minocycline for acne has been previously described as transient effect and/or associated with autoimmune thyroiditis. We report nonimmune-mediated thyroid dysfunction associated with minocycline/doxycycline in 3 adolescents whose clinical courses suggest an adverse effect that may be more common, serious, and persistent than realized previously.

Topics: Acne Vulgaris; Adolescent; Anti-Bacterial Agents; Diplopia; Fatigue; Female; Headache; Humans; Hyperthyroidism; Male; Minocycline; Polydipsia; Thyrotropin; Thyroxine; Weight Loss

Topics: Abdominal Pain; Adolescent; Anti-Bacterial Agents; Back Pain; Diagnosis, Differential; Diplopia; Emergency Nursing; Female; Humans; Medical History Taking; Minocycline; Nausea; Nursing Assessment; Physical Examination; Pseudotumor Cerebri

To demonstrate the association between minocycline treatment and development of the pseudotumor cerebri syndrome.. A retrospective study was conducted of 12 patients from five neuro-ophthalmic referral centers who developed pseudotumor cerebri syndrome after being treated with standard doses of minocycline for refractory acne vulgaris. The main outcome measures included resolution of headaches, transient visual obscurations, diplopia, papilledema, and visual fields static thresholds after withdrawal of minocycline and treatment for increased intracranial pressure.. Nine (75%) of the 12 patients developed symptoms of the pseudotumor cerebri syndrome syndrome within 8 weeks of starting minocycline therapy; six were not obese. Two patients developed symptoms only after a year had elapsed because of commencement of treatment with minocycline. One patient was asymptomatic, and pseudotumor cerebri syndrome was diagnosed by finding papilledema on routine examination 1 year after minocycline was started. None of the patients developed recurrences for at least 1 year after the discontinuation of minocycline and treatment for increased intracranial pressure, but three (25%) of the 12 patients had substantial residual visual field loss.. Minocycline is a cause or precipitating factor in pseudotumor cerebri syndrome. Although most patients have prominent symptoms and are diagnosed promptly, others are asymptomatic and may have optic disk edema for a long period of time before diagnosis. Withdrawal of minocycline and treatment for increased intracranial pressure lead to resolution of the pseudotumor cerebri syndrome, but visual field loss may persist.

Topics: Acne Vulgaris; Adolescent; Adult; Anti-Bacterial Agents; Diplopia; Female; Follow-Up Studies; Headache; Humans; Intracranial Pressure; Minocycline; Papilledema; Pseudotumor Cerebri; Retrospective Studies; Syndrome; Vision Disorders; Visual Acuity

A 16-year-old girl complained about a headache of one-month's duration, accompanied by vertical diplopia that had appeared ten days earlier. The girl reported receiving vitamin A and minocycline to treat acne vulgaris for the previous six weeks. An examination revealed bilateral optic disc edema. Normal computed tomographic and magnetic resonance imaging examinations enabled a diagnosis of pseudotumor cerebri to be made. Soon after discontinuation of those medications, the headaches and diplopia diminished. We suggest a periodic ophthalmologic examination during systemic therapy with vitamin A combined with minocycline to detect the early occurrence of pseudotumor cerebri.

Topics: Acne Vulgaris; Adolescent; Diplopia; Drug Therapy, Combination; Female; Fundus Oculi; Headache; Humans; Magnetic Resonance Imaging; Minocycline; Papilledema; Pseudotumor Cerebri; Tomography, X-Ray Computed; Vitamin A