Coexistent minocycline-induced systemic lupuserythematosus and autoimmune hepatitis

Angulo, J Carlos; Sigal, Leonard H.; Espinoza, Luis R.

doi:10.1016/s0049-0172(98)80035-8

Cited by 55 publications

(29 citation statements)

References 27 publications

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“…The musculoskeletal manifestations were frequently accompanied by constitutional symptoms such as fever, malaise, fatigue, anorexia or weight loss. Liver involvement sometimes diagnosed as (auto-immune) hepatitis was reported in 31 patients (54%) [10, 17, 20, 21, 26, 27, 31, 32, 34, 35, 36, 38, 39, 40, 42, 43, 44, 45]. Typically, transaminases were mildly or severely elevated (alanine transaminase: range 106–916 IU; aspartate aminotransferase: range 87–2,294 IU), while alkaline phosphatase or γ-glutamyltransferase were normal or only mildly increased.…”

Section: Resultsmentioning

confidence: 99%

“…Typically, transaminases were mildly or severely elevated (alanine transaminase: range 106–916 IU; aspartate aminotransferase: range 87–2,294 IU), while alkaline phosphatase or γ-glutamyltransferase were normal or only mildly increased. Jaundice was present in 3 patients [10, 20]. …”

Section: Resultsmentioning

confidence: 99%

“…Twelve patients had evidence of dermatological manifestations [20, 22, 39, 40, 42]presenting as ‘rash’ in 7 patients (rash not specified in 3; maculopapular, malar, urticarial, vasculitic rash reported in 1 case each), livedo reticularis (n = 2) [22], oral ulcer (n = 1) [40], subcutaneous nodules (n = 2) [41], hyperpigmentation (n = 1) [42]and alopecia (n = 2) [39, 40]. …”

Section: Resultsmentioning

confidence: 99%

“…Minocycline-related adverse effects include dose-dependent gastro-intestinal intolerance as well as a variety of hypersensitivity reactions, such as maculopapular, morbilliform or erythematous rashes, photosensitivity, hyperpigmentation [15, 16], single-organ dysfunction [17, 18], serum-sickness-like reaction [17, 18, 19], auto-immune hepatitis [10, 19, 20, 21], anti-myeloperoxidase-positive vasculitis-like syndrome [22]and drug-induced hypersensitivity syndrome [17, 18, 23]. Furthermore, since a first case description in 1992 [24], minocycline has been increasingly associated with DIL [10, 11, 17, 18, 19].…”

Section: Introductionmentioning

confidence: 99%

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Minocycline-Induced Lupus

Bircher²,

2000

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Background: Minocycline has increasingly been associated with different adverse auto-immune reactions including drug-induced lupus. Objective: To identify the scope of minocycline-induced lupus and to characterise its typical features. Methods: Comprehensive Medline and Embase search of the English and non-English literature for case reports of minocycline-induced lupus. Results: We included 57 cases of minocycline-induced lupus (mean age ± SD at onset: 21.6 ± 8.6 years, median time of exposure: 19 months, range 3 days to 6 years). All patients showed the clinical features of polyarthralgia/polyarthritis often accompanied by liver abnormalities. Twelve patients had evidence of dermatological manifestations (i.e rash, livedo reticularis, oral ulceration, subcutaneous nodules, alopecia). The ANA test was positive in all patients. Conclusion: Long-term exposure to minocycline may be associated with drug-induced lupus. Baseline and periodic liver function and ANA tests accompanied by appropriate clinical monitoring are suggested for patients receiving long-term minocycline therapy.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Minocycline-Induced Lupus

Bircher²,

2000

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“…Hydroxychloroquine (in rare cases) has also been linked to liver inflammation [139,141]. In a 1998 review, Angulo linked Minocycline to 60 cases of druginduced SLE, 24 cases of AIH and an additional 13 cases of overlapping symptoms including arthritis, elevated LFTs and a positive ANA [160]. Elkayam found a similar combination of AIH and symptoms of drug induced lupus in 66 patients who had been taking Minocycline, 63 of which had a positive ANA [161].…”

Section: Other Liver Diseasesmentioning

confidence: 99%

The Gastrointestinal Manifestations of Systemic Lupus Erythematosus: A Survey of the Literature

Schulz¹,

Derk²

2009

TOAUTOJ

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Systemic Lupus Erythematosus (SLE) is an autoimmune disease associated with auto-antibody production and resulting widespread inflammation that has potential to affect and damage many organ systems. Gastrointestinal manifestations of SLE are well documented in the literature but the exact extent and frequency of their presence is likely grossly underestimated. Patients present with vague complaints such as abdominal pain and nausea with non-specific physical exam findings and inconclusive diagnostic tests and serologic analysis. Recent research has helped to better clarify these manifestations of SLE and has demonstrated distinct involvement of almost every portion of the GI tract. This article is based upon an exhaustive review of the literature from 1976 to present date and summarizes the major advances in the identification and differentiation of gastrointestinal incarnations related to systemic lupus erythematosus. The review also encompasses theories of etiology of the various manifestations, summarizes accepted and experimental treatment regimens, and highlights the differential diagnosis of each presented topic, including disorders of the oropharynx, esophagus, stomach, small and large intestine, liver and gallbladder and beyond.

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