MINOCYCLINE INDUCED ARTHRITIS-ASSOCIATED WITH FEVER, LIVEDO-RETICULARIS, AND PANCA

Objective-to describe a novel iatrogenic immunological reaction produc ed by minocycline. Case reports-The clinical course and laboratory res ults of three women who presented with similar rheumatological manifes tations after a prolonged exposure to minocycline are described. All t hree presented a unique reaction manifested by fever, arthritis/arthra lgia and livedo reticularis during treatment with minocycline for acne vulgaris. The clinical syndrome was associated with high titre of ser um perinuclear anticytoplasmatic antibodies (p-ANCA) and antimyelopero xidase antibody (anti-MPO). Symptoms resolved after stopping the drug and recurred promptly after rechallenge in all three patients. Conclus ions-Minocycline, which is widely used in the treatment of acne, often without adequate supervision, may induce arthritis and livedo vasculi tis associated with anti-MPO.