Drug-induced lupus erythematosus

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Drug-induced lupus erythematosus
File:Hydralazine.svg Chemical structure of hydralazine, a drug known to induce lupus
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Arthralgia, myalgia, fever, serositis, rash
Complications	N/A
Onset	Weeks to months after drug exposure
Duration	Symptoms resolve after discontinuation of the drug
Types	N/A
Causes	Hydralazine, procainamide, isoniazid, quinidine, minocycline, phenytoin, sulfasalazine, diltiazem, carbamazepine
Risks	Prolonged use of certain medications
Diagnosis	Clinical evaluation, antinuclear antibody (ANA) test, anti-histone antibody test
Differential diagnosis	Systemic lupus erythematosus, rheumatoid arthritis, polymyositis
Prevention	N/A
Treatment	Discontinuation of the offending drug, nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids
Medication	N/A
Prognosis	Generally good with drug discontinuation
Frequency	Rare
Deaths	N/A

Drug-induced lupus erythematosus (DILE) is an autoimmune disease that occurs as a result of long-term use of certain medications. It is similar to systemic lupus erythematosus (SLE) but is generally less severe and resolves after the discontinuation of the offending drug.

Pathophysiology

DILE is characterized by the production of autoantibodies against the body's own tissues, leading to inflammation and tissue damage. The exact mechanism by which drugs induce lupus is not fully understood, but it is believed to involve the alteration of immune system function by the drug, leading to an autoimmune response.

Commonly Implicated Drugs

Several drugs have been implicated in the development of DILE. These include:

• Hydralazine
• Procainamide
• Isoniazid
• Quinidine
• Minocycline

Hydralazine, in particular, is a well-known cause of DILE and is used in the treatment of hypertension.

Clinical Features

The symptoms of DILE are similar to those of SLE but are generally milder. Common symptoms include:

• Arthralgia (joint pain)
• Myalgia (muscle pain)
• Fever
• Serositis (inflammation of the serous tissues)
• Rash

Unlike SLE, DILE rarely affects the kidneys or central nervous system.

Diagnosis

The diagnosis of DILE is based on the clinical presentation, history of drug exposure, and laboratory findings. Key laboratory findings include the presence of antinuclear antibodies (ANA) and anti-histone antibodies, which are commonly associated with DILE.

Treatment

The primary treatment for DILE is the discontinuation of the offending drug. Symptoms typically resolve within weeks to months after stopping the drug. In some cases, nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroids may be used to manage symptoms.

Prognosis

The prognosis for patients with DILE is generally good, as symptoms usually resolve after the drug is discontinued. However, it is important to monitor patients for any persistent symptoms that may indicate the development of SLE.

See also

• Systemic lupus erythematosus
• Autoimmune disease
• Antinuclear antibody