Limits...
Vasculitic neuropathy following exposure to minocycline.

Baratta JM, Dyck PJ, Brand P, Thaisetthawatkul P, Dyck PJ, Engelstad JK, Goodman B, Karam C - Neurol Neuroimmunol Neuroinflamm (2015)

Bottom Line: Symptoms developed with either early or prolonged use of minocycline.Despite withdrawal of minocycline, patients needed long-term immunotherapy to gain neurologic improvement.Our findings suggest that the typical neuropathy associated with minocycline use is painful single or multiple mononeuropathy due to peripheral nerve vasculitis, which may also be accompanied by presumed CNS vasculitis (presenting as stroke).

View Article: PubMed Central - PubMed

Affiliation: Departments of Physical Medicine & Rehabilitation (J.M.B.) and Neurology (C.K.), The University of North Carolina, Chapel Hill; the Department of Neurology (P.J.B.D., P.B., P.J.D., J.K.E.), Mayo Clinic, Rochester, MN; the Department of Neurological Sciences (P.T.), University of Nebraska Medical Center, Omaha; and the Department of Neurology (B.G.), Mayo Clinic, Scottsdale, AZ.

ABSTRACT

Objective: To report 3 patients with minocycline-induced autoimmunity resulting in peripheral nerve vasculitis.

Methods: We report 3 patients who, during minocycline treatment for acne vulgaris, developed subacute onset of pain and weakness caused by vasculitis in single and multiple mononeuropathy patterns.

Results: Each patient underwent either a nerve or muscle biopsy that confirmed vasculitis. One patient additionally developed systemic symptoms (including fever, fatigue, and night sweats) and another had a posterior circulation stroke. Symptoms developed with either early or prolonged use of minocycline. Despite withdrawal of minocycline, patients needed long-term immunotherapy to gain neurologic improvement.

Conclusions: Our findings suggest that the typical neuropathy associated with minocycline use is painful single or multiple mononeuropathy due to peripheral nerve vasculitis, which may also be accompanied by presumed CNS vasculitis (presenting as stroke).

No MeSH data available.


Related in: MedlinePlus

Patient 2 gastrocnemius muscle biopsy10Gomori trichrome stain of gastrocnemius muscle biopsy shows large arteriole necrotizing vasculitis.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4645168&req=5

Figure 2: Patient 2 gastrocnemius muscle biopsy10Gomori trichrome stain of gastrocnemius muscle biopsy shows large arteriole necrotizing vasculitis.

Mentions: An ANA was mildly positive (1:160) and a thyroid peroxidase antibody level was elevated (19.34). Autoimmune and infectious workups were otherwise negative. No imaging was performed. Electrophysiology studies demonstrated an isolated left, subacute, primarily axonal, tibial mononeuropathy. A left gastrocnemius muscle biopsy was consistent with necrotizing vasculitis (figure 2).


Vasculitic neuropathy following exposure to minocycline.

Baratta JM, Dyck PJ, Brand P, Thaisetthawatkul P, Dyck PJ, Engelstad JK, Goodman B, Karam C - Neurol Neuroimmunol Neuroinflamm (2015)

Patient 2 gastrocnemius muscle biopsy10Gomori trichrome stain of gastrocnemius muscle biopsy shows large arteriole necrotizing vasculitis.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4645168&req=5

Figure 2: Patient 2 gastrocnemius muscle biopsy10Gomori trichrome stain of gastrocnemius muscle biopsy shows large arteriole necrotizing vasculitis.
Mentions: An ANA was mildly positive (1:160) and a thyroid peroxidase antibody level was elevated (19.34). Autoimmune and infectious workups were otherwise negative. No imaging was performed. Electrophysiology studies demonstrated an isolated left, subacute, primarily axonal, tibial mononeuropathy. A left gastrocnemius muscle biopsy was consistent with necrotizing vasculitis (figure 2).

Bottom Line: Symptoms developed with either early or prolonged use of minocycline.Despite withdrawal of minocycline, patients needed long-term immunotherapy to gain neurologic improvement.Our findings suggest that the typical neuropathy associated with minocycline use is painful single or multiple mononeuropathy due to peripheral nerve vasculitis, which may also be accompanied by presumed CNS vasculitis (presenting as stroke).

View Article: PubMed Central - PubMed

Affiliation: Departments of Physical Medicine & Rehabilitation (J.M.B.) and Neurology (C.K.), The University of North Carolina, Chapel Hill; the Department of Neurology (P.J.B.D., P.B., P.J.D., J.K.E.), Mayo Clinic, Rochester, MN; the Department of Neurological Sciences (P.T.), University of Nebraska Medical Center, Omaha; and the Department of Neurology (B.G.), Mayo Clinic, Scottsdale, AZ.

ABSTRACT

Objective: To report 3 patients with minocycline-induced autoimmunity resulting in peripheral nerve vasculitis.

Methods: We report 3 patients who, during minocycline treatment for acne vulgaris, developed subacute onset of pain and weakness caused by vasculitis in single and multiple mononeuropathy patterns.

Results: Each patient underwent either a nerve or muscle biopsy that confirmed vasculitis. One patient additionally developed systemic symptoms (including fever, fatigue, and night sweats) and another had a posterior circulation stroke. Symptoms developed with either early or prolonged use of minocycline. Despite withdrawal of minocycline, patients needed long-term immunotherapy to gain neurologic improvement.

Conclusions: Our findings suggest that the typical neuropathy associated with minocycline use is painful single or multiple mononeuropathy due to peripheral nerve vasculitis, which may also be accompanied by presumed CNS vasculitis (presenting as stroke).

No MeSH data available.


Related in: MedlinePlus