Systemic reactions induced by minocycline treatment: a report of four patients and a review of the literature.

We report four cases of the side effects of minocylcine seen during the las t two years in our department. There was one case of drug-related lupus and three cases of hypersensitivity reactions, including one eosinophilic pnem opathy with pericarditis, one nephropathy and one severe, pseudo-infectious episode of high fever, rash, lympadenopathy, hepatitis and eosinophilia. Minocycline is a tetracycline agent widely used for acne therapy iii France and all over the world. During the last few years, there has been an incre asing number of reports concerning systemic adverse reactions to minocyclin e, with on the one hand auto-immune disorders (lupus, autoimmune hepatitis, vascularitis with ANCA), occurring after a prolonged course of therapy and reported recently in the last few gears, and on the other hand, hypersensi tivity reactions (eosinophilic pneumopathies, hepatitis, nephropathies, myo carditis, serum sickness or pseudoinfectious reactions), occurring precocio usly in the course of therapy and potentially severe. Although these side effects are uncommon bl the context of the high number of patients who have been prescribed the drug, the first-line antibiotic th erapy in acne must probably be reconsidered (C) 1999 Editions scientifiques et medicales Elsevier SAS.