minocycline and Mononeuropathies

We describe 2 patients presenting with multiplex mononeuritis, associated with skin manifestation, secondary to minocycline-induced vasculitis. One of the cases is associated neither with lupus nor polyarteritis nodosa. An extensive laboratory workup ruled out any possible underlying immunologic disorder. Electrodiagnostic studies were conducted to show axonal neuropathy in patchy and multifocal distribution consistent with multiplex mononeuritis. This diagnosis was confirmed with nerve biopsy. Withdrawing from the offending medication, minocycline, improved the patients' clinical condition and the quantitative serological measures.

Topics: Adult; Anti-Bacterial Agents; Anti-Inflammatory Agents; Biopsy; Female; Humans; Male; Middle Aged; Minocycline; Mononeuropathies; Muscle, Skeletal; Neural Conduction; Peripheral Nerves; Prednisone; Vasculitis

Topics: Adolescent; Humans; Knee; Male; Minocycline; Mononeuropathies; Prednisone; Vasculitis

We present an unusual case of a patient with scrub typhus who developed acalculous cholecystitis, aseptic meningitis and mononeuritis multiplex. The patient was successfully treated with oral minocycline. To our knowledge, this is the first report of mononeuritis multiplex caused by scrub typhus.

Topics: Abdomen; Acalculous Cholecystitis; Administration, Oral; Aged; Anti-Bacterial Agents; Female; Humans; Knee; Meningitis, Aseptic; Minocycline; Mononeuropathies; Radiography, Abdominal; Scrub Typhus; Skin; Tomography, X-Ray Computed; Treatment Outcome; Ultrasonography

Minocycline is an antibiotic used for the treatment of acne. It has been associated with several autoimmune syndromes, including drug-induced lupus, autoimmune hepatitis, and vasculitis.. We report a case of a 28-year-old previously healthy woman who developed a left sciatic mononeuropathy 2 weeks after starting minocycline for acne. Magnetic resonance imaging studies supported the localization. A biopsy of the left sural nerve revealed acute nerve large arteriole necrotizing vasculitis. Her condition improved after the withdrawal of minocycline and a course of treatment with methylprednisolone.. This case provides further evidence that minocycline may induce a nonsystemic necrotizing vasculitis.

Topics: Adult; Anti-Bacterial Agents; Female; Humans; Minocycline; Mononeuropathies; Sciatic Neuropathy; Treatment Outcome; Vasculitis

A 70-year-old woman was admitted to our hospital because of fever, numbness in her extremities and right drop foot. Because her hip prosthesis had loosened as a result of infection, she had been taking 100 mg of minocycline orally for eight months. Three months before admission, she had had melena several times and body weight loss and pyrexia developed. A month before admission, asymmetrical paresthesia and numbness appeared in her extremities and finally right drop foot developed. Laboratory tests showed elevated C-reactive protein and positive anti-nuclear antibody. Abnormalities found in nerve conduction study were compatible with mononeuritis multiplex. Sural nerve biopsy revealed an occluded medium-size artery in the epineurium and axonal degeneration in the nerve fascicles, confirming the diagnosis of vasculitic neuropathy. These manifestations met the American Congress Rheumatology criteria for polyarteritis nodosa. However, her clinical conditions markedly improved after discontinuing minocycline and therefore she was diagnosed as having minocycline-induced vasculitic neuropathy. Although minocycline-induced vasculitis is a well known adverse effect of the drug, peripheral neuropathy with biopsy findings has rarely been reported. Drug induced-vasculitis is important as a differential diagnosis for mononeuritis multiplex because the symptoms can be improved by the discontinuation of an offending drug.

Topics: Aged; Anti-Bacterial Agents; Antibodies, Antinuclear; Biomarkers; C-Reactive Protein; Diagnosis, Differential; Female; Hip Prosthesis; Humans; Minocycline; Mononeuropathies; Neural Conduction; Peripheral Nervous System Diseases; Prosthesis-Related Infections; Sural Nerve; Vasculitis