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

Klaas, James P.; Matzke, Thomas; Makol, Ashima; Fulgham, Jimmy R.

doi:10.1016/j.jocn.2014.12.003

Cited by 9 publications

(5 citation statements)

References 11 publications

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“…Minocycline use has been associated with drug-induced lupus 1,2 and polyarteritis nodosa-like vasculitis including two cases with ischemic stroke. 3,4 Another report 5 described the association of lupus-like syndrome and antiphospholipid antibodies induced by minocycline but the patient did not develop any clinical manifestation of APS. Other drugs have been considered as possibly causing APS but only in a limited number of patients.…”

Section: Discussionmentioning

confidence: 99%

Reversible drug-induced antiphospholipid syndrome

Risse

Vieira

Beuret

et al. 2017

Lupus

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We report an original case of reversible antiphospholipid syndrome (APS) due to minocycline in a young male patient who experienced recurrent strokes while taking minocycline. He started minocycline therapy (50 mg twice daily) at 15 years old for acne. After three years of treatment, the patient experienced a lateral medullary syndrome. He was treated with aspirin while minocycline was continued. Eighteen months later, the patient complained about horizontal binocular diplopia. MRI revealed an infarct of the oculomotor nerve nucleus. Laboratory investigations revealed high titers of anti-beta 2 glycoprotein 1 (antiβ2GP1) antibodies of 470 U/ml (normal range <15 U/ml) and antiphosphatidylethanolamine antibodies of 137.4 U/ml (normal range <18 U/ml). Other laboratory tests were normal. Six weeks after discontinuation of minocycline, anti-β2GP1 antibodies decreased to 335 U/ml and to 36 U/ml at six months and then remained negative for six years. Many drugs have been considered as possibly causing APS but only in a limited number of patients. To our knowledge this is the first case of drug-induced APS with complete disappearance of high titers of anti-β2GP1 antibodies after minocycline withdrawal. This case also illustrates the need to monitor the levels of antiphospholipid antibodies, even though initial values are high and confirmed after 12 weeks.

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Section: Discussionmentioning

confidence: 99%

Reversible drug-induced antiphospholipid syndrome

Risse

Vieira

Beuret

et al. 2017

Lupus

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“…It is also known as a powerful inhibitor of matrix metalloproteinases (MMPs) [ 14 - 17 ]. Furthermore, the pharmacological effects of minocycline on several neurological disorders have been evidenced, including stroke [ 18 , 19 ], multiple sclerosis [ 13 , 20 ], Alzheimer’s disease [ 21 ], and other neurodegenerative disorders [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

Ameliorating Alzheimer’s-like Pathology by Minocycline via Inhibiting Cdk5/p25 Signaling

Zhang

Wang

et al. 2022

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Background: Minocycline has multiple neuroprotective roles in abundant brain diseases, including the prevention and treatment of Alzheimer’s disease (AD). Cdk5/p25 signaling plays an important role in the onset and development of Alzheimer’s-like pathology. The aim of the present work was to further explore the underlying mechanism which minocycline effects on Cdk5/p25 signaling related to the Alzheimer’s-like pathology. Methods: The cognitive function of animals was measured by the Morris water maze test. The levels of Aβ were determined by enzyme-linked immunosorbent assay. The levels of APP, β- and γ-secretases; and the biomarkers of tau (total tau and hyperphosphorylated tau), inflammatory cytokine and matrix metalloproteinases (MMP-2 and MMP-9), biomarkers of synapse and Cdk5/p25 signaling were detected by Western blotting. The biomarkers of synapse, inflammatory cytokine and matrix metalloproteinases (MMP-2 and MMP-9) were also determined by immunofluorescence. Results: Minocycline improved learning and memory in APP/PS1 mice. Minocycline limits the production of Aβ and hyperphosphorylation of tau in the hippocampus, and ameliorates synaptic deficit while minocycline inhibits the activation of Cdk5/p25 signaling, inflammation and activation of matrix metalloproteinases. Conclusion: Minocycline mitigates Alzheimer’s-like pathology via limiting the activation of Cdk5/p25 signaling pathway and improves cognitive deficits.

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“…Certain medications have known associations with drug‐induced ANCA‐associated vasculitis, such as antithyroid drugs (most commonly propylthiouracil), hydralazine, antitumor necrosis factor‐alpha agents (e.g., infliximab), sulfasalazine, D‐penicillamine, phenytoin, and leukotriene receptor antagonists (eg, montelukast) . Minocycline, an antibiotic often used in the treatment of acne vulgaris, has been associated with drug‐induced p‐ANCA‐positive vasculitis and, although less reported, arthritis as well. Isotretinoin can be added to this list .…”

Section: Discussionmentioning

confidence: 99%

Perinuclear antineutrophil cytoplasmic antibody–positive vasculitis, oligoarthritis, tendinitis, and myositis associated with isotretinoin in a 15‐year‐old boy: Case report and review of literature

Mangodt

Joos

Siozopoulou

et al. 2018

Pediatric Dermatology

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We present a patient in whom a combination of perinuclear antineutrophil cytoplasmic antibody-positive vasculitis, oligoarthritis, tendinitis, and myositis was considered to be associated with isotretinoin use. Discontinuation of the drug resulted in complete clinical and biochemical remission (normalization of perinuclear antineutrophil cytoplasmic antibody titer). Although we were unable to prove causality, no other underlying cause for the patient's course was found. We report this occurrence to bring it to the attention of physicians prescribing isotretinoin.

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

Cited by 9 publications

References 11 publications

Reversible drug-induced antiphospholipid syndrome

Reversible drug-induced antiphospholipid syndrome

Ameliorating Alzheimer’s-like Pathology by Minocycline via Inhibiting Cdk5/p25 Signaling

Perinuclear antineutrophil cytoplasmic antibody–positive vasculitis, oligoarthritis, tendinitis, and myositis associated with isotretinoin in a 15‐year‐old boy: Case report and review of literature

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