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

• Published in: Journal of clinical neuroscience Vol. 22; no. 5; pp. 904 - 907
• Main Authors: Klaas, James P, Matzke, Thomas, Makol, Ashima, Fulgham, Jimmy R
• Format: Journal Article
• Language: English
• Published: Scotland Elsevier Ltd 01-05-2015
• Subjects: Adult; Anti-Bacterial Agents - adverse effects; Brain Stem Infarctions - chemically induced; Brain Stem Infarctions - diagnosis; Diagnosis, Differential; Female; Humans; Minocycline; Minocycline - adverse effects; Neurology; Pharmacology; Polyarteritis nodosa; Polyarteritis Nodosa - chemically induced; Polyarteritis Nodosa - diagnosis; Stroke; Vasculitis; Vasculitis, Central Nervous System - chemically induced; Vasculitis, Central Nervous System - diagnosis; Minocycline; Stroke; Pharmacology; Vasculitis; Polyarteritis nodosa
• ISSN: 0967-5868; 1532-2653
• DOI: 10.1016/j.jocn.2014.12.003

Abstract 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.