Minocycline-Induced Polyarteritis Nodosa Presenting With Testicular Pain: A Case Report and Selected Review of the Literature

Polyarteritis nodosa (PAN) is a systemic necrotizing vasculitis that affects small and medium-sized arteries, leading to aneurysm formation and ischemia in different organs of the body. Although not common, testicular manifestations have been documented. We discuss a case of 18-year-old male with minocycline-induced systemic PAN who presented with unilateral testicular pain. The definitive diagnosis was made after testicular biopsy demonstrating focally necrotizing vasculitis affecting small and medium vessels. Following the diagnosis he was discharged on prednisone, and was started on rituximab by his rheumatologist. He is clinically much improved during his surveillance follow-up visits with his rheumatologist and urologist. Minocycline-induced polyarteritis nodosa can present with constitutional symptoms and testicular pain among patients using the acne treatment. Prompt diagnosis is essential to ensure proper treatment and prevention of complications. Optimal management of these patients requires close collaboration amongst urologists and rheumatologists for accurate tissue diagnosis and close surveillance. World J Nephrol Urol. 2018;7(1):32-37 doi: https://doi.org/10.14740/wjnu337w