Minocycline-induced polyarteritis nodosa-like vasculitis presenting as brainstem stroke. 2015

James P Klaas, and Thomas Matzke, and Ashima Makol, and Jimmy R Fulgham
Department of Neurology, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, USA. Electronic address: klaas.james@mayo.edu.

Minocycline use has been associated with the development of autoimmune disorders, including drug-induced vasculitis. Previously published reports suggest that clinical manifestations are limited to cutaneous, constitutional, or musculoskeletal symptoms. To our knowledge there has been only one reported patient with ischemic stroke in the setting of minocycline-induced vasculitis. We describe a 26-year-old woman, with no vascular risk factors, who had an ischemic pontine stroke in the setting of biopsy-proven minocycline-induced polyarteritis nodosa-like vasculitis. Discontinuation of minocycline resulted in resolution of the vasculitis, and she has not had any recurrent ischemic events. This report shows that ischemic strokes may occur as a result of minocycline-induced vasculitis. While this is likely a rare association, recognition is important given the widespread use of minocycline and the potential for devastating consequences in a young population. Consequently, drug-induced vasculitis should be considered in patients with an ischemic stroke taking minocycline.

UI MeSH Term Description Entries
D008911 Minocycline A TETRACYCLINE analog, having a 7-dimethylamino and lacking the 5 methyl and hydroxyl groups, which is effective against tetracycline-resistant STAPHYLOCOCCUS infections. Akamin,Akne-Puren,Aknemin,Aknin-Mino,Aknosan,Apo-Minocycline,Arestin,Blemix,Cyclomin,Cyclops,Dentomycin,Dynacin,Icht-Oral,Klinomycin,Lederderm,Mestacine,Minakne,Mino-Wolff,Minocin,Minocin MR,Minoclir,Minocycline Hydrochloride,Minocycline Monohydrochloride,Minocycline, (4R-(4 alpha,4a beta,5a beta,12a beta))-Isomer,Minolis,Minomycin,Minoplus,Minotab,Minox 50,Mynocine,Akne Puren,Aknin Mino,Apo Minocycline,Hydrochloride, Minocycline,Icht Oral,Mino Wolff,Monohydrochloride, Minocycline
D010488 Polyarteritis Nodosa A form of necrotizing non-granulomatous inflammation occurring primarily in medium-sized ARTERIES, often with microaneurysms. It is characterized by muscle, joint, and abdominal pain resulting from arterial infarction and scarring in affected organs. Polyarteritis nodosa with lung involvement is called CHURG-STRAUSS SYNDROME. Essential Polyarteritis,Necrotizing Arteritis,Periarteritis Nodosa,Arteritides, Necrotizing,Arteritis, Necrotizing,Essential Polyarteritides,Necrotizing Arteritides,Polyarteritides, Essential,Polyarteritis, Essential
D003937 Diagnosis, Differential Determination of which one of two or more diseases or conditions a patient is suffering from by systematically comparing and contrasting results of diagnostic measures. Diagnoses, Differential,Differential Diagnoses,Differential Diagnosis
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000900 Anti-Bacterial Agents Substances that inhibit the growth or reproduction of BACTERIA. Anti-Bacterial Agent,Anti-Bacterial Compound,Anti-Mycobacterial Agent,Antibacterial Agent,Antibiotics,Antimycobacterial Agent,Bacteriocidal Agent,Bacteriocide,Anti-Bacterial Compounds,Anti-Mycobacterial Agents,Antibacterial Agents,Antibiotic,Antimycobacterial Agents,Bacteriocidal Agents,Bacteriocides,Agent, Anti-Bacterial,Agent, Anti-Mycobacterial,Agent, Antibacterial,Agent, Antimycobacterial,Agent, Bacteriocidal,Agents, Anti-Bacterial,Agents, Anti-Mycobacterial,Agents, Antibacterial,Agents, Antimycobacterial,Agents, Bacteriocidal,Anti Bacterial Agent,Anti Bacterial Agents,Anti Bacterial Compound,Anti Bacterial Compounds,Anti Mycobacterial Agent,Anti Mycobacterial Agents,Compound, Anti-Bacterial,Compounds, Anti-Bacterial
D020293 Vasculitis, Central Nervous System Inflammation of blood vessels within the central nervous system. Primary vasculitis is usually caused by autoimmune or idiopathic factors, while secondary vasculitis is caused by existing disease process. Clinical manifestations are highly variable but include HEADACHE; SEIZURES; behavioral alterations; INTRACRANIAL HEMORRHAGES; TRANSIENT ISCHEMIC ATTACK; and BRAIN INFARCTION. (From Adams et al., Principles of Neurology, 6th ed, pp856-61) Angiitis, Central Nervous System,Central Nervous System Vasculitis,Cerebral Angiitis,Cerebral Vasculitis,Granulomatous Angiitis,Postzoster Arteritis,Primary CNS Vasculitis,Secondary CNS Vasculitis,CNS Vasculitis,Central Nervous System Angiitis,Granulomatous Arteritis,Primary Central Nervous System Vasculitis,Vasculitis, CNS, Secondary,Angiitis, Cerebral,Angiitis, Granulomatous,Arteritis, Granulomatous,Arteritis, Postzoster,CNS Vasculitis, Primary,CNS Vasculitis, Secondary,Vasculitis, CNS,Vasculitis, Cerebral,Vasculitis, Primary CNS,Vasculitis, Secondary CNS
D020526 Brain Stem Infarctions Infarctions that occur in the BRAIN STEM which is comprised of the MIDBRAIN; PONS; and MEDULLA OBLONGATA. There are several named syndromes characterized by their distinctive clinical manifestations and specific sites of ischemic injury. Benedict Syndrome,Brain Stem Infarct,Claude Syndrome,Foville Syndrome,Millard-Gublar Syndrome,Top of the Basilar Syndrome,Weber Syndrome,Brainstem Infarctions,Brainstem Stroke,Infarctions, Brain Stem,Infarctions, Brainstem,Brain Stem Infarction,Brain Stem Infarcts,Brainstem Infarction,Infarct, Brain Stem,Infarction, Brain Stem,Infarction, Brainstem,Infarcts, Brain Stem,Millard Gublar Syndrome,Stem Infarct, Brain,Stem Infarcts, Brain,Stroke, Brainstem,Syndrome, Millard-Gublar

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