MINOCYCLINE-INDUCED ARTHRITIS

We describe seven women who developed acute polyarthritis after prolon ged treatment with minocycline for acne. Arthritis persisted until min ocycline was withdrawn, then recovered rapidly. A mild elevation of al anine or aspartate transaminase was noted in 4 patients, while pulmona ry infiltrates were found in 2 patients. Antinuclear antibodies (ANA) were persistently present throughout treatment in 4 patients, but were only present on one occasion in 2 women and were absent in one. This syndrome has been described as ''drug-induced lupus'' although, as des cribed with other drugs, many patients do not fulfil the diagnostic cr iteria for lupus. The proposed criteria for the diagnosis of ''drug-in duced lupus'', which require only one clinical feature of SLE, also re quire a positive ANA test and therefore might exclude these patients. This could result in failure to recognise minocycline as the cause of the arthritis, and hence lead to prolonged illness and unnecessary inv estigations and treatment.