Minocycline-associated autoimmunity

Article Outline

• Copyright

In this issue of The Journal, El-Hallak et al from Boston report their experience with 27 adolescents referred to The Children's Hospital Rheumatology Program with minocycline-associated autoimmune disorders, primarily polyarthralgia and polyarthritis affecting the hands and feet. The lengthy duration of minocycline use prior to diagnosis (mean 13 months) and lengthy course of clinical autoimmune disease in one-quarter of patients following discontinuation (mean 32 months) are remarkable.

In an accompanying editorial, Moore categorizes the laboratory and clinical manifestations of drug-induced autoimmune disease and puts the Boston minocycline experience in context. Considering that more than 15 million prescriptions for minocycline are doled out to pediatric patients annually in the United States (the vast majority for treatment of adolescent acne), pediatricians should be vigilant that serious autoimmune disorders can follow, continuously assess the treatment dose and duration, and be alert for adverse events.