No abstract

We report the case of an 18-year-old woman with arthralgia and swelling of distal joints at hands and feet, photosensitive reaction, butterfly rash, fatigue, tachypnea and unspecific cardiac pain three months after beginning a treatment with minocycline for acne. Recurrence of symptoms at a higher intensity occurred within hours of reexposition with minocycline. The antinuclear antibody test was positive. After withdrawal of minocycline, the symptoms improved and minocycline-induced lupus was diagnosed. In the Swissmedic and WHO adverse drug reaction databases 267 other cases of possible minocycline-induced lupus were identified. Typical clinical and laboratory features are arthralgia, arthritis, myalgia, increased transaminases and/or jaundice, unspecific symptoms like fatigue and fever, skin disorders and positive antinuclear antibodies.

were due to the effects of brachytherapy and not to the use of metallic clips or EBRT.In conclusion, although surgery remains the first choice to treat ROLC, a considerable number of patients are inoperable. EBRT is an alternative, but is hampered since the ROLC is effectively invisible. We report that the use of metallic clips placed during bronchoscopy can make ROLC visible for the radiation oncologist. The clips appear to be safe, well tolerated and removable in inoperable patients with ROLC who are candidates for EBRT. In the future, this technique could facilitate EBRT or even stereotactical beam radiotherapy in patients with ROLC. Prospective studies further investigating this technique are warranted.