Remission of Angiographically Confirmed Minocycline-induced Renal Polyarteritis Nodosa: A Case Report and Literature Review

Kenichi Yokota; Isao Kurihara; Toshifumi Nakamura; Seishi Nakatsuka; Kazutoshi Miyashita; Sakiko Kobayashi; Ayano Murai-Takeda; Masakatsu Sone; Hiroshi Itoh

doi:10.2169/internalmedicine.7340-21

CASE REPORTS

Remission of Angiographically Confirmed Minocycline-induced Renal Polyarteritis Nodosa: A Case Report and Literature Review

Kenichi Yokota, Isao Kurihara, Toshifumi Nakamura, Seishi Nakatsuka, Kazutoshi Miyashita, Sakiko Kobayashi, Ayano Murai-Takeda, Masakatsu Sone, Hiroshi Itoh

Author information

Kenichi Yokota
Department of Internal Medicine, Keio University School of Medicine, Japan
Isao Kurihara
Department of Internal Medicine, Keio University School of Medicine, Japan
Toshifumi Nakamura
Department of Internal Medicine, Keio University School of Medicine, Japan
Seishi Nakatsuka
Department of Radiology, Keio University School of Medicine, Japan
Kazutoshi Miyashita
Department of Internal Medicine, Keio University School of Medicine, Japan
Sakiko Kobayashi
Department of Internal Medicine, Keio University School of Medicine, Japan
Ayano Murai-Takeda
Department of Internal Medicine, Keio University School of Medicine, Japan
Masakatsu Sone
Division of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine, Japan
Hiroshi Itoh
Department of Internal Medicine, Keio University School of Medicine, Japan

Keywords: aneurysms, angiography, drug-induced vasculitis, minocycline, polyarteritis nodosa, renovascular hypertension

JOURNAL OPEN ACCESS

2022 Volume 61 Issue 1 Pages 103-110

DOI https://doi.org/10.2169/internalmedicine.7340-21

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Abstract

A 23-year-old man presented with severe hypertension. Based on his history of minocycline treatment for over three years and clinical symptoms, such as myalgias and renovascular hypertension with multiple intrarenal aneurysms, he was diagnosed with minocycline-induced renal polyarteritis nodosa (PAN). After minocycline treatment cessation and management of the hypertension, his blood pressure, renin-aldosterone levels, and urinary protein levels gradually improved. Seven and a half years later, repeated angiography found that the aneurysms had resolved. This is the first report in English describing a case of minocycline-induced renal PAN that was reversed functionally and morphologically without steroids or immunosuppressive drugs.

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