A case of anaphylaxis to oral minocycline

Abstract

Minocycline is a semisynthetic tetracycline derivative that is often used in the treatment of acne vulgaris. To date, there has been only one case report of anaphylaxis to minocycline. We report here a case of anaphylaxis to oral minocycline. A 56-yr-old woman visited our hospital after three episodes of recurrent anaphylaxis. We performed an oral challenge test, the standard method for diagnosing drug allergies, with minocycline, one of the drugs she had taken previously. She developed urticaria, angioedema, nausea, vomiting, hypotension, and dyspnea within 4 min and was treated with intramuscular epinephrine, intravenous antihistamine and systemic corticosteroid. However, she presented similar symptoms at 50 min and at 110 min. In prescribing oral minocycline, physicians should consider the possibility of serious adverse reactions, such as anaphylaxis.

Keywords: Allergy; Anaphylaxis; Minocycline; Oral Challenge Test.

Fig. 1

Development of periorbital and perioral angioedema within 4 min after taking oral minocycline.

Fig. 2

Changes in blood pressure following an oral minocycline challenge test. Arrows indicate times at which drugs were administered, including epinephrine, antihistamine, and systemic corticosteroids.