Doxycycline-Induced Antinuclear Antibody and Antineutrophil Cytoplasmic Antibody Associated Vasculitis: A Case Report and Literature Review.

Autor: Wriston DJ; Department of Internal Medicine, Geisinger Medical Center, Danville, Pennsylvania, USA., Norfolk ER; Department of Nephrology, Geisinger Medical Center, Danville, Pennsylvania, USA., Smith LM; Department of Nephrology, Geisinger Medical Center, Danville, Pennsylvania, USA., Chen G; Department of Pathology, Geisinger Medical Center, Danville, Pennsylvania, USA., Bulbin DH; Department of Rheumatology, Geisinger Medical Center, Danville, Pennsylvania, USA.
Jazyk: angličtina
Zdroj: Case reports in rheumatology [Case Rep Rheumatol] 2020 Aug 27; Vol. 2020, pp. 3853671. Date of Electronic Publication: 2020 Aug 27 (Print Publication: 2020).
DOI: 10.1155/2020/3853671
Abstrakt: Drug-induced antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) has been increasingly recognized in the literature with numerous medications listed as causative agents in disease pathology. Doxycycline is a commonly prescribed medication within the United States which is a synthetic, broad-spectrum antibiotic with antimicrobial properties and at low doses exhibits anti-inflammatory effects. In this report, we describe a case of doxycycline-induced ANCA-associated vasculitis with laboratory and biopsy findings supporting the diagnosis, which to the best of our knowledge is the first described case of doxycycline-induced AAV in the literature. The patient was started on doxycycline for treatment of potential Lyme disease. She began to develop progressively worsening myasthenia, erythematous macular rash, anorexia, anemia, and fatigue for several weeks following the course of doxycycline with initial concern of a paraneoplastic process. Ultimately, the patient was discovered to be positive for antinuclear antibody (ANA), perinuclear antineutrophil cytoplasmic antibody (pANCA), and myeloperoxidase (MPO) antibody for which she was treated with a course of prednisone leading to complete remission of disease. A brief review of the pathogenesis of ANCA vasculitides will also be discussed within this article.
Competing Interests: There are no conflicts of interest in this case report.
(Copyright © 2020 Davisson J. Wriston et al.)
Databáze: MEDLINE
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