minocycline and Drug-Hypersensitivity

Drug-induced liver injury (DILI) with features of autoimmunity (AI) represents an important category of hepatotoxicity due to medication exposure. Drugs repeatedly associated with AI-DILI include diclofenac, α-methyl DOPA, hydralazine, nitrofurantoin, minocycline, and more recently statins and anti-TNF-α agents. Usually, symptoms of acute liver injury occur within a few months after initiation of a culprit medication, but a longer latency period is possible. Like idiopathic autoimmune hepatitis, circulating autoantibodies and a hypergammaglobulinemia are frequently present in sera from patients with AI-DILI. If performed, a liver biopsy should demonstrate interface hepatitis with a prominent plasma cell infiltrate. The severity of AI-DILI is variable, but a complete resolution after withdrawal of the offending medication is the expectation. A response to corticosteroid therapy supports the diagnosis, whereas a lack of recurrence of symptoms or signs following corticosteroid cessation distinguishes AI-DILI from idiopathic autoimmune hepatitis.

Topics: Adult; Anti-Bacterial Agents; Anti-Infective Agents, Urinary; Antihypertensive Agents; Autoantibodies; Autoimmunity; Chemical and Drug Induced Liver Injury; Cytokines; Diagnosis, Differential; Drug Hypersensitivity; Female; Hepatitis, Autoimmune; HLA Antigens; Humans; Hydralazine; Hypergammaglobulinemia; Liver; Liver Function Tests; Male; Methyldopa; Minocycline; Nitrofurantoin; Time Factors; Young Adult

Minocycline is the most widely prescribed systemic antibiotic for the management of acne. In the past several years, increasing attention has been paid to the drug, both for its potential use as a disease-modifying antirheumatic agent and for its propensity to engender untoward autoimmune reactions, including serum sickness-like disease, drug-induced lupus, and autoimmune hepatitis. This paper reviews the evidence for minocycline as an anti-inflammatory and immunomodulatory agent, its utility in the treatment of rheumatoid arthritis, and the spectrum of adverse reactions that have been ascribed to the drug in the past 5 years.

Topics: Acne Vulgaris; Animals; Anti-Bacterial Agents; Arthritis; Arthritis, Rheumatoid; Autoimmune Diseases; Chemical and Drug Induced Liver Injury; Drug Hypersensitivity; Female; Humans; Lupus Erythematosus, Systemic; Male; Minocycline; Vasculitis

We report four cases of the side effects of minocycline seen during the last two years in our department. There was one case of drug-related lupus and three cases of hypersensitivity reactions, including one eosinophilic pneumopathy with pericarditis, one nephropathy and one severe, pseudo-infectious episode of high fever, rash, lympadenopathy, hepatitis and eosinophilia. Minocycline is a tetracycline agent widely used for acne therapy in France and all over the world. During the last few years, there has been an increasing number of reports concerning systemic adverse reactions to minocycline, with on the one hand auto-immune disorders (lupus, autoimmune hepatitis, vascularitis with ANCA), occurring after a prolonged course of therapy and reported recently in the last few years, and on the other hand, hypersensitivity reactions (eosinophilic pneumopathies, hepatitis, nephropathies, myocarditis, serum sickness or pseudo-infectious reactions), occurring precociously in the course of therapy, and potentially severe. Although these side effects are uncommon in the context of the high number of patients who have been prescribed the drug, the first-line antibiotic therapy in acne must probably be reconsidered.

Topics: Adolescent; Adult; Anti-Bacterial Agents; Drug Hypersensitivity; Eosinophilia; Female; Humans; Kidney Diseases; Lung Diseases; Lupus Vulgaris; Male; Minocycline

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

Minocycline is the most commonly used systemic antibiotic in the long-term treatment (weeks to months) of severe acne vulgaris. Currently much attention is being paid in the Dutch and international literature to the safety of minocycline, after several reports on serious adverse events. The clinical efficacy of minocycline in the treatment of acne vulgaris is better than that of tetracycline and equal to that of doxycycline. The serious adverse events of minocycline therapy described consist of hyperpigmentation of various tissues, autoimmune disorders (systemic lupus erythematosus, autoimmune hepatitis) and serious hypersensitivity reactions (hypersensitivity syndrome reaction, pneumonitis and eosinophilia, and serum sickness-like syndrome). In relation to the number of prescriptions, the number of serious adverse events of minocycline described is small. However, it is very important that prescribing doctors should be aware of the possibility of these adverse events occurring during long-term minocycline therapy and able to recognize the characteristic symptoms at an early stage.

Topics: Acne Vulgaris; Anti-Bacterial Agents; Drug Hypersensitivity; Hepatitis, Autoimmune; Humans; Lupus Erythematosus, Systemic; Minocycline; Pigmentation Disorders; Pulmonary Eosinophilia; Serum Sickness; Syndrome

Minocycline has been reported to cause serious, albeit rare, adverse events, including serum sickness-like reaction, hypersensitivity syndrome reaction, and drug-induced lupus. A retrospective review of patients seen in our Adverse Drug Reaction Clinic as well as information obtained from the Health Protection Branch was done to identify patients with minocycline-induced reactions. In addition, the literature concerning serious reactions to minocycline was reviewed.. Six patients with a hypersensitivity syndrome reaction, 6 patients with a serum sickness-like reaction, and 1 patient who had symptoms consistent with drug-induced lupus were identified. A review of the literature identified 11 cases of hypersensitivity syndrome reaction, 1 case of serum sickness-like reaction, and 24 cases of drug-induced lupus. Serum sickness-like reactions occur sooner than hypersensitivity syndrome reactions (15.6 vs 23.7 days, P = .04). Drug-induced lupus occurs on average 2 years after the start of minocycline therapy.. Dermatologists need to be aware of the serious adverse reactions that can develop after minocycline use. In patients who may require long-term therapy with minocycline ( > 1 year), we suggest that antinuclear antibody and hepatic transaminase levels be determined at baseline. Rechallenge with minocycline or other tetracyclines is currently not recommended for patients who develop these serious reactions.

Topics: Adolescent; Adult; Anti-Bacterial Agents; Drug Hypersensitivity; Female; Humans; Male; Minocycline; Retrospective Studies

Topics: Acne Vulgaris; Adult; Drug Hypersensitivity; Female; Humans; Minocycline; Pulmonary Eosinophilia

A 65-year-old man developed respiratory failure with diffuse interstitial shadow, bilateral pleural effusion, and bilateral hilar lymphadenopathy on chest X-ray and CT, after intravenous administration of minocycline. Corticosteroid therapy was effective. The findings from bronchoalveolar lavage (BAL) and transbronchial lung biopsy were compatible with eosinophilic pneumonia. Provocation test supported this diagnosis, but the lymphocyte stimulation test was negative. A review of the literature and the diagnoses of drug-induced pulmonary diseases are discussed.

Topics: Aged; Drug Hypersensitivity; Humans; In Vitro Techniques; Lymphatic Diseases; Lymphocyte Activation; Male; Minocycline; Pleural Effusion; Prednisolone; Pulmonary Eosinophilia

Topics: Aminoglycosides; Anti-Bacterial Agents; Anti-Infective Agents, Urinary; Bacterial Infections; Bacteroides Infections; Cephalosporins; Drug Hypersensitivity; Haemophilus Infections; Humans; Meningococcal Infections; Minocycline; Penicillin Resistance; Penicillins; Streptococcal Infections; Typhoid Fever

Topics: Abdominal Abscess; Acute Kidney Injury; Aged; Anti-Bacterial Agents; beta-Lactams; Drug Hypersensitivity; Humans; Male; Minocycline; Radiography; Tigecycline

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare serious adverse effect associated with a variety of medications. We present a case of minocycline-induced DRESS syndrome, which resulted in acute renal failure, transient thyroiditis, and transaminitis, and a persistent lymphocytic myocarditis resulting in congestive heart failure. To our knowledge, this is the third reported case of minocycline-induced myocarditis. Additionally, we report successful plasmapheresis and rituximab treatment for minocycline-induced myocarditis associated with the DRESS syndrome.

Topics: Acne Vulgaris; Adult; Antibodies, Monoclonal; Antibodies, Monoclonal, Murine-Derived; Drug Eruptions; Drug Hypersensitivity; Eosinophilia; Female; Humans; Minocycline; Myocarditis; Plasmapheresis; Rituximab

Drug rash, eosinophilia, and systemic symptoms syndrome is a type of drug hypersensitivity reaction characterized by the clinical triad of skin eruption, fever, and internal organ involvement. Drug rash, eosinophilia, and systemic symptoms syndrome has rarely been reported in association with vancomycin or in the pediatric population. There have only been four pediatric case reports of drug rash, eosinophilia, and systemic symptoms syndrome and three cases of drug rash, eosinophilia, and systemic symptoms syndrome involving vancomycin published in the English literature to date.. We describe two pediatric cases of drug rash, eosinophilia, and systemic symptoms syndrome to illustrate the range in severity of presentation. The first case illustrates drug rash, eosinophilia, and systemic symptoms syndrome associated with vancomycin exposure in a 14-yr-old boy with Duchenne muscular dystrophy after posterior spinal fusion, whose clinical presentation was indistinguishable from toxic shock syndrome. The second case illustrates a milder and more typical presentation of drug rash, eosinophilia, and systemic symptoms syndrome in a 14-yr-old boy being treated with minocycline for acne. We also present a review of the literature relevant to this syndrome.. : Drug rash, eosinophilia, and systemic symptoms syndrome is relatively unknown among general pediatricians and pediatric intensivists and may potentially become more common with the increasing use of long-term medications in the pediatric population. Our cases demonstrate the importance of an awareness of drug rash, eosinophilia, and systemic symptoms syndrome among general pediatricians and pediatric intensivists because drug rash, eosinophilia, and systemic symptoms syndrome may present in any range of severity, from indolent illness to frank and refractory shock.

Topics: Adolescent; Anti-Bacterial Agents; Diagnosis, Differential; Drug Hypersensitivity; Eosinophilia; Exanthema; Humans; Male; Minocycline; Severity of Illness Index; Shock, Septic; Syndrome; Vancomycin

Minocycline is a semisynthetic tetracycline derivative that is often used in the treatment of acne vulgaris. To date, there has been only one case report of anaphylaxis to minocycline. We report here a case of anaphylaxis to oral minocycline. A 56-yr-old woman visited our hospital after three episodes of recurrent anaphylaxis. We performed an oral challenge test, the standard method for diagnosing drug allergies, with minocycline, one of the drugs she had taken previously. She developed urticaria, angioedema, nausea, vomiting, hypotension, and dyspnea within 4 min and was treated with intramuscular epinephrine, intravenous antihistamine and systemic corticosteroid. However, she presented similar symptoms at 50 min and at 110 min. In prescribing oral minocycline, physicians should consider the possibility of serious adverse reactions, such as anaphylaxis.

Topics: Administration, Oral; Anaphylaxis; Anti-Bacterial Agents; Drug Hypersensitivity; Female; Humans; Middle Aged; Minocycline; Recurrence

A 52-year-old Japanese woman was referred to our Institute because of Helicobacter pylori(H. pylori)-positive gastric mucosa-associated lymphoid tissue(MALT)lymphoma. Since she had a penicillin allergy, we could not eradicate H. pylori using the standard triple therapy including amoxicillin. Additionally, H. pylori was resistant to both clarithromycin and metronidazole. So she was treated with minomycin (MINO), levofloxacin (LVFX), and rabeprazole (RPZ) based on a drug sensitivity test. MINO+LVFX+RPZ appear to be a promising, appropriate, and well-tolerated eradication regimen for H. pylori demonstrating resistance to both clarithromycin and metronidazole, and for patients who are allergic to penicillin.

Topics: 2-Pyridinylmethylsulfinylbenzimidazoles; Biopsy; Drug Hypersensitivity; Female; Helicobacter Infections; Helicobacter pylori; Humans; Levofloxacin; Lymphoma, B-Cell, Marginal Zone; Middle Aged; Minocycline; Ofloxacin; Penicillins; Rabeprazole

We assessed the adherence to the prescribing hospital protocol for tigecycline and factors associated with noncompliance. A total of 103 patients were included in the study. In 23 (22.3%) patients, tigecycline was not administered according to the protocol, mostly because of the availability of other therapeutic alternatives and prescription for indications that were not included in the guidelines. factors independently associated with nonadherence to the protocol were community-acquired infection (OR, 14.01; 95% CI, 1.54-127.12; P=0.019), and empirical tigecycline treatment (OR, 6.97; 95% CI, 0.88-55.40; P=0.066). penicillin allergy (OR, 0.004; 95% CI, 0.000-0.071; P=0.001) and previous antibiotic treatment (OR, 0.025; 95% CI, 0.003-0.233; P=0.001) were factors associated with adherence to the hospital protocol. A positive time trend between total number of prescriptions and non-compliant prescriptions with the protocol was observed (Spearman's rho coefficient 0.971; P=0.001). Adherence to tigecycline protocol could be improved by focusing on protocols for community-acquired infections, mainly skin and soft tissue infections.

Topics: Anti-Bacterial Agents; Bacterial Infections; beta-Lactam Resistance; Clinical Protocols; Community-Acquired Infections; Drug Hypersensitivity; Female; Guideline Adherence; Hospitals, University; Humans; Male; Medical Order Entry Systems; Minocycline; Penicillins; Practice Guidelines as Topic; Retrospective Studies; Tigecycline; Treatment Outcome

Drug hypersensitivity syndrome (DHS) is a severe, multisystem adverse drug reaction that may occur following the use of numerous medications, including anticonvulsants, sulfonamides, and minocycline hydrochloride. Long-term autoimmune sequelae of DHS have been reported, including hypothyroidism.. A 15-year-old female adolescent developed DHS 4 weeks after starting minocycline therapy for acne vulgaris. Seven weeks later she developed autoimmune hyperthyroidism (Graves disease), and 7 months after discontinuing minocycline therapy she developed autoimmune type 1 diabetes mellitus. In addition, she developed elevated titers of several markers of systemic autoimmune disease, including antinuclear, anti-Sjögren syndrome A, and anti-Smith antibodies.. Minocycline-associated DHS may be associated with multiple autoimmune sequelae, including thyroid disease, type 1 diabetes mellitus, and elevated markers of systemic autoimmunity. Long-term follow-up is needed in patients with DHS to determine the natural history of DHS-associated sequelae.

Topics: Acne Vulgaris; Adolescent; Anti-Bacterial Agents; Autoimmune Diseases; Diabetes Mellitus, Type 1; Drug Hypersensitivity; Female; Graves Disease; Humans; Minocycline

Topics: Anti-Bacterial Agents; Drug Hypersensitivity; Humans; Hypereosinophilic Syndrome; Lymphomatoid Papulosis; Male; Middle Aged; Minocycline

(1) In mid-2008 the French National Pharmacovigilance Committee examined spontaneous reports of adverse effects observed during tetracycline therapy; (2) When sales figures are taken into account, reports were more frequent with minocycline than with doxycycline. The proportion of severe adverse effects was also higher with minocycline than with doxycycline; (3) Life-threatening hypersensitivity reactions and autoimmune adverse effects were more frequent with minocycline than with doxycycline; (4) In practice, minocycline has a less favourable risk-benefit balance than doxycycline, particularly in the treatment of acne.

Topics: Acne Vulgaris; Autoimmune Diseases; Doxycycline; Drug Hypersensitivity; Drug-Related Side Effects and Adverse Reactions; France; Humans; Minocycline

Minocycline-induced drug rash with eosinophilia and systemic symptoms (DRESS) may have a prolonged course, especially in African and African-American patients.. To determine if a prolonged course of minocycline-induced DRESS was associated with an accumulation of the culprit drug.. We determined plasma and skin levels of minocycline in patients with minocycline-induced DRESS. We investigated the genetic polymorphisms of enzymes potentially involved in the detoxification of the drug, glutathione S-transferases and UDP-glucuronosyltransferases.. We demonstrated the persistence of minocycline in the plasma and/or in the skin of 7 out of 9 patients with skin phototypes V-VI. As pigmented skin contains more melanin, this could promote the formation of a melanin-minocycline complex, which could explain the severe and prolonged DRESS which may occur in this subgroup of patients.

Topics: Acne Vulgaris; Adolescent; Adult; Anti-Bacterial Agents; Black People; Chromatography, High Pressure Liquid; Drug Hypersensitivity; Eosinophilia; Female; Genetic Predisposition to Disease; Genotype; Glutathione Transferase; Humans; Male; Melanins; Middle Aged; Minocycline; Polymerase Chain Reaction; Polymorphism, Genetic; Sequence Deletion; Skin; Skin Pigmentation; Syndrome

Topics: Aged; Anti-Bacterial Agents; Carbamazepine; Drug Hypersensitivity; Female; Humans; Immunosuppressive Agents; Isoxazoles; Minocycline; Pemphigoid, Bullous; Pharyngitis; Syndrome; Time Factors; Treatment Outcome; Trigeminal Neuralgia; Zonisamide

Topics: Acne Vulgaris; Adult; Anti-Bacterial Agents; Critical Care; Drug Hypersensitivity; Female; Humans; Lymphocyte Activation; Minocycline; Respiratory Distress Syndrome; T-Lymphocytes

Topics: Adult; Anti-Bacterial Agents; Drug Hypersensitivity; Eosinophilia; Herpesvirus 6, Human; Humans; Male; Minocycline; Roseolovirus Infections

Topics: Acne Vulgaris; Adult; Anti-Bacterial Agents; Drug Hypersensitivity; Female; Humans; Minocycline; Rhabdomyolysis; Syndrome

Topics: Adult; Anti-Bacterial Agents; Asthma; Conjunctiva; Drug Hypersensitivity; Female; Humans; Hypereosinophilic Syndrome; Minocycline

The current data suggest that local delivery of antimicrobials into the periodontal pocket can improve periodontal health. However, they do not provide a superior result to scaling and root planing. In conjunction with scaling and root planing, the adjunctive use of local drug delivery devices may enhance the results in sites which do not respond to conventional therapy.

Topics: Anti-Bacterial Agents; Anti-Infective Agents, Local; Chlorhexidine; Doxycycline; Drug Hypersensitivity; Drug Resistance, Microbial; Humans; Minocycline; Periodontal Pocket; Periodontitis; Tetracycline

Topics: Anti-Bacterial Agents; Drug Eruptions; Drug Hypersensitivity; Humans; Minocycline; Syndrome

A 22-year-old black man developed fever, chills, fatigue, night sweats, tender lymphadenopathy, and a generalized, pruritic, macular eruption 3 weeks after starting minocycline therapy for acne. His illness was also characterized by a palpable spleen tip, marked lower extremity and scrotal edema, and generalized lymphadenopathy. The patient had leukocytosis with a large percentage of atypical lymphocytes on peripheral smear and liver dysfunction. Titers for Epstein-Barr virus, hepatitis B, toxoplasmosis; and cytomegalovirus were all negative. Human immunodeficiency virus-1 viral load and antibodies were also negative. Marked improvement was noted after the discontinuation of minocycline and the use of systemic corticosteroids. With the negative viral serologies, the clinical picture was most consistent with an infectious mononucleosis-like syndrome produced by the minocycline ingestion.

Topics: Acne Vulgaris; Adult; Anti-Bacterial Agents; Diagnosis, Differential; Drug Hypersensitivity; Humans; Infectious Mononucleosis; Male; Minocycline; Syndrome

We report the case of a 19-year old black West Indian woman who had been treated for acne for two years with oral minocycline (50 mg per day) and topical of benzoyle peroxide (5%). She was admitted for fatigue, arthralgia, myalgia and widespread pruritus. We observed several skin lesions of hyperpigmentation, biological signs of hepatitis, and significant levels of antinuclear, anti-mitochondrial and anti-smooth muscle antibodies. Minocycline was immediately stopped. Two months later, all of the biological abnormalities had disappeared but the skin lesions seemed to be irreversible. Minocycline is largely used for the treatment of acne and may induce severe immuno-allergic reactions. Several cases of induced lupus, autoimmune hepatitis, eosinophilic pneumonia, hypersensitivity syndrome, serum-sickness-like illness and Sweet's syndrome have already been described. These side effects are rare but may be life-threatening. So, minocycline should be used as a second-line treatment for acne and should be avoided in black people whom seem to be at risk of such reactions. If, despite those precautions, minocycline-induced immuno-allergic reactions occur, the treatment should be immediately stopped and never prescribed again.

Topics: Adult; Anti-Bacterial Agents; Chemical and Drug Induced Liver Injury; Drug Hypersensitivity; Female; Humans; Minocycline

Topics: Anti-Bacterial Agents; Drug Hypersensitivity; HIV Seronegativity; Humans; Male; Minocycline; Neurosyphilis; Penicillin G

We report a case of minocycline-induced pneumonitis. A 30-year-old woman was treated with minocycline for mycoplasma pneumonia of the right upper lobe. About 15 days after starting treatment, she developed a productive cough, stridor, and dyspnea. The chest X-ray film showed pulmonary infiltration in the left middle lung field. Based on the clinical history and the detection of eosinophilia in the bronchoalveolar fluid, drug-induced pneumonitis was suspected. Treatment with minocycline was discontinued and prednisolone (20 mg/day) was started, after which her symptoms subsided and there was marked regression of the pulmonary infiltrates on chest X-ray films. The lymphocyte stimulation test for minocycline was negative, but the diagnosis was confirmed by a positive oral provocation test.

Topics: Adult; Asthma; Drug Hypersensitivity; Female; Humans; Minocycline; Pneumonia; Respiratory Hypersensitivity

A patient is reported who developed dyspnoea, fever, pleuritic chest pain and a non-productive cough following treatment with minocycline for 9 days. The chest radiograph showed an interstitial pattern and there was a peripheral eosinophilia. A diagnosis of hypersensitivity pneumonitis attributable to minocycline was made. The disease responded quickly to withdrawal of the drug. This observation shows that minocycline, despite its mild toxicity profile, can give rise to serious adverse effects.

Topics: Alveolitis, Extrinsic Allergic; Drug Hypersensitivity; Female; Humans; Middle Aged; Minocycline

Minocycline is a tetracycline agent frequently used for acne therapy. It has a few rare but severe side effects that are not widely known but should be recognized early as drug related. These include acute hepatitis and liver failure; a Löffler-like syndrome with pulmonary infiltrates, wheezing, fever, and eosinophilia; skin eruptions, eosinophilic cellulitis, and pustular folliculitis with eosinophilia; and a lupuslike syndrome. Side effects that are better known and recognized include photosensitization, skin exanthema with pruritus, and pseudotumor cerebri.

Topics: Acne Vulgaris; Adult; Drug Eruptions; Drug Hypersensitivity; Eosinophilia; Female; Fever; Humans; Liver; Lymphatic Diseases; Minocycline; Neutropenia

Acute pulmonary eosinophilia was observed in the patient after taking minocycline. The clinical picture recurred when the drug was re-introduced. However, this is a rare complication after taking a derivative of tetracycline. An eosinophilia was seen in the peripheral blood and also in the bronchoalveolar lavage. Cessation of the drug therapy without the addition of corticosteroids allowed a cure.

Topics: Acne Vulgaris; Adult; Bronchoalveolar Lavage Fluid; Drug Hypersensitivity; Eosinophilia; Humans; Male; Minocycline; Pulmonary Eosinophilia

Topics: Drug Hypersensitivity; Female; Humans; Minocycline; Pulmonary Fibrosis

Topics: Adolescent; Drug Hypersensitivity; Female; Humans; Minocycline

To identify the cause of a hypersensitivity pneumonitis and to determine its pathogenesis.. Case study.. Intensive care unit of a referral hospital.. A 51-year-old man with chronic bronchitis who developed a hypersensitivity pneumonitis within 1 month after exposure to minocycline, amoxicillin, and erythromycin.. Sequential bronchoalveolar lavages after reexposure to minocycline and amoxicillin.. Immunologic analysis of the phenotype and function of alveolar lymphocytes.. Reexposure to minocycline but not to amoxicillin was followed by an interstitial pneumonitis. Sequential bronchoalveolar lavages showed a transient rise of eosinophils and neutrophils and a persistent alveolar lymphocytosis. Alveolar lymphocytes consisted predominantly of CD8+ but also CD4+ cells. Two CD8+ lymphocyte subsets were identified: CD8+ D44+ cytotoxic T cells that increased rapidly after the drug was resumed and CD8+ CD57+ suppressor T cells that predominated 11 days after the drug's withdrawal. In-vitro assays showed the presence of a lymphocyte-mediated specific cytotoxicity against minocycline-bearing alveolar macrophages.. These results support the hypothesis of a central role of T lymphocytes in the pathogenesis of drug-related hypersensitivity pneumonitis.

Topics: Alveolitis, Extrinsic Allergic; Bronchoalveolar Lavage Fluid; Cytotoxicity, Immunologic; Drug Hypersensitivity; Humans; Immunity, Cellular; Immunophenotyping; Leukocyte Count; Macrophages, Alveolar; Male; Middle Aged; Minocycline; Pulmonary Alveoli; T-Lymphocytes

A rare side effect of minocycline is acute eosinophilic pneumonia. In the literature only ten cases have been reported. We report two cases of minocycline which induced (eosinophilic) alveolitis. A high fever, dry cough, dyspnoea and fatigue are the main features of the clinical picture. Peripheral blood eosinophilia and elevated total IgE content were seen in one patient. Bronchoalveolar lavage in this patient revealed eosinophilia. Transbronchial lung biopsies showed infiltration with eosinophilic granulocytes in both patients. Airway macrophages contained brown-black pigment granules. In the acute stage an important decrease in diffusion capacity was observed. The pulmonary and systemic symptoms promptly cleared up after discontinuation of minocycline. Provocation with minocycline was positive, because both patients noticed the same symptoms within one day.

Topics: Adult; Bronchoalveolar Lavage Fluid; Drug Hypersensitivity; Humans; Male; Middle Aged; Minocycline; Pulmonary Eosinophilia; Rosacea

A 19 year-old youth was taking oral minocycline and after 8 days he presented all four cardinal symptoms of serum sickness (urticaria, fever, lymphadenopathy and joint symptoms). C3, C4 and CH50 evolution imitate experimental serum sickness complement evolution. We exclude other causes of this syndrome. Although other hypersensitivity reactions have occurred with minocycline usage, to our knowledge serum sickness-like syndrome has not been previously reported with this drug.

Topics: Adult; Drug Hypersensitivity; Humans; Male; Minocycline; Serum Sickness; Syndrome; Tetracyclines; Time Factors

A severe hypersensitivity-like illness with acute renal failure, lymphadenopathy and skin rash is reported following minocycline treatment in a 16 year old male. Following haemodialysis and steroid therapy his illness remitted, only to recur on withdrawal of the steroids. With further steroid treatment he recovered completely. Lymphocyte function tests, performed in an attempt to positively incriminate minocycline, were inconclusive due to a general suppression of the patient's lymphocytes to in vitro stimulation. Hypersensitivity reactions attributed to minocycline include skin rashes, lymphadenopathy and one previous case of acute interstitial nephritis.

Topics: Adolescent; Drug Hypersensitivity; Humans; Male; Minocycline; Nephritis, Interstitial; Tetracyclines

The study of the dynamics of biogenic amines in the blood of patients provided to a certain extent determination of the possible thread of the drug complications. In this respect the serotonin level was of special significance. As for the reaction of leucocyte agglomeration it may be used before the treatment if there is a doubt in the tolerance of the antibacterial drug prescribed. Increased serotonin blood levels in this case also serve a confirmation of the thread of the possible allergic or toxic reaction in the patient.

Topics: 11-Hydroxycorticosteroids; Administration, Oral; Adult; Ampicillin; Anti-Bacterial Agents; Carbenicillin; Ceruloplasmin; Doxycycline; Drug Hypersensitivity; Drug Interactions; Female; Histamine; Humans; Injections, Intramuscular; Leukocytes; Male; Middle Aged; Minocycline; Pivampicillin; Serotonin; Tetracyclines; Time Factors; Tryptophan

Topics: Adolescent; Adult; Drug Hypersensitivity; Female; Humans; Male; Meningitis, Meningococcal; Middle Aged; Minocycline; Tetracyclines

Topics: Administration, Oral; Anemia, Hemolytic; Blood-Brain Barrier; Chlortetracycline; Demeclocycline; Doxycycline; Drug Hypersensitivity; Female; Glucosephosphate Dehydrogenase Deficiency; Gonorrhea; Humans; Injections, Intramuscular; Intestinal Absorption; Male; Methacycline; Minocycline; Oxytetracycline; Penicillins; Tetracycline; Urethritis

Topics: Administration, Oral; Aged; Dermatitis, Contact; Drug Hypersensitivity; Humans; Male; Minocycline; Skin Tests; Tetracycline; Urinary Tract Infections