Pediatr Gastroenterol Hepatol Nutr.  2018 Oct;21(4):347-350. 10.5223/pghn.2018.21.4.347.

Minocycline-Induced Autoimmune Hepatitis: A Rare But Important Cause of Drug-Induced Autoimmune Hepatitis

• Harmon EG
• McConnie R
• Kesavan A

• KMID: 2421999
• DOI: http://doi.org/10.5223/pghn.2018.21.4.347

Abstract

Drug-induced autoimmune hepatitis (DIAIH) is an increasingly recognized form of drug-induced liver injury that leads to a condition similar to idiopathic autoimmune hepatitis. A number of drugs have been associated with DIAIH, minocycline is one of the most well characterized. Minocycline is a semisynthetic tetracycline antibiotic used in the treatment of acne vulgaris. Minocycline-induced autoimmune hepatitis presents with serologic and histologic features similar to idiopathic autoimmune hepatitis. However, the natural history and outcomes of these two conditions differ significantly. The majority of patients with minocycline-induced autoimmune hepatitis experience complete resolution of symptoms after withdrawal of the medication. Some patients may require a short course of steroids and rarely use of an immunomodulator to achieve resolution of disease. Recurrence of symptoms is rare and typically only occurs with reintroduction of minocycline. It is important for primary care providers to consider minocycline-induced autoimmune hepatitis when liver injury develops during minocycline therapy.

Keyword

Chemical and drug induced liver injury; Minocycline; Autoimmune hepatitis

MeSH Terms

Acne Vulgaris
Drug-Induced Liver Injury
Hepatitis, Autoimmune*
Humans
Liver
Minocycline
Natural History
Primary Health Care
Recurrence
Steroids
Tetracycline
Minocycline
Steroids
Tetracycline

Figure

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  Fig. 1 Rosetting and few sinusoidal mature lymphocytes (H&E, ×200).

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  Fig. 2 Increased plasma cells (H&E, ×400).

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  Fig. 3 Reticulin stain showing periportal fibrosis (reticulin stain, ×100).

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