Nitrofurantoin and Minocycline-Associated Vasculitic Neuropathy: Case Reports and Literature Review

Mohammad Aladawi, Shahar Shelly, P. James B. Dyck, Matthew Koster, Janean Engelstad, Ezequiel A. Piccione, Elie Naddaf

Research output: Contribution to journalReview articlepeer-review


Background:Vasculitic neuropathies usually present acutely to subacutely, with an asymmetric pattern, involving multiple peripheral nerve territories. Drug-induced vasculitis is an often overlooked etiology of vasculitic neuropathy.Methods:We present the first reported case of nitrofurantoin-associated and an illustrative case of minocycline-associated vasculitic neuropathy, with a review of the literature.Results:The first patient is a 60-year-old woman who developed axonal sensorimotor peripheral neuropathy after nitrofurantoin use, with a superficial radial nerve biopsy confirming vasculitis. The second patient is a 23-year-old woman, with a history of acne vulgaris treated with minocycline, who presented with a subacute right common peroneal mononeuropathy followed by a left deep peroneal mononeuropathy, with elevated antinuclear, perinuclear-antineutrophil cytoplasmic, and myleoperoxidase antibodies, and MPO titers, and a sural nerve biopsy showing large arteriole vasculitis. Finally, we provide a comprehensive review of previously published cases.Conclusions:Medications should be considered as a trigger for medication-induced vasculitic neuropathy. Accurate diagnosis would ensure timely treatment.

Original languageEnglish (US)
Pages (from-to)85-94
Number of pages10
JournalJournal of clinical neuromuscular disease
Issue number2
StatePublished - Dec 1 2022


  • drug-induced vasculitis
  • minocycline
  • nitrofurantoin
  • peripheral neuropathy
  • vasculitic neuropathy

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


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