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Minocycline has become one of the most commonly used treatments for acne, and has also been used to treat autoimmune conditions, especially rheumatoid arthritis. But a retrospective study highlights
the drug's potential for occasionally
inducing serious autoimmune phenomena. Fatma Dedeoglu, MD, and colleagues in Children's Program in Rheumatology, reviewed the cases of 27 children with minocycline-induced autoimmunity seen
in their practice, the largest reported series to date. The children (mean age 16.5 years) had been taking minocycline for a mean of nearly 14 months. All
presented with constitutional symptoms such as fever, weight loss and malaise. Twenty-two had polyarthralgia and 17
had polyarthritis, mostly affecting hands and feet. Fourteen patients had rapid symptom resolution when minocycline was discontinued, and another six had symptoms resolve within 12 months, but seven developed chronic autoimmune
disease, primarily arthritis, which remained active at last follow-up (mean of 32 months after onset). While this complication is fairly rare, clinicians
should consider it in patients on
minocycline who develop constitutional
or musculoskeletal symptoms, and promptly discontinue the drug. (Journal
of Pediatrics online, April 25)
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