DRUG INDUCED LUPUS

SUMMARY

1. Classic drug-induced lupus (DIL) can be caused by procainamide, hydralazine, chlorpromazine, propylthiouracil, phenytoin, and TNF inhibitors.

2. Patients develop constitutional symptoms (fever, arthralgias), serositis, rash while taking any of the above drugs.

3. ANA & anti-histone antibody are positive. C3 and C4 usually are normal, anti-dsDNA is rarely positive, and there commonly is no kidney or CNS involvement.

4. Treatment: symptoms usually resolve within 4-8 weeks after stopping the offending agent. NSAIDs and anti-malarials can be used.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].