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For further information, see CMDT Part 20-08: Drug-Induced Lupus

Key Features

  • Shares several clinical and serologic features with systemic lupus erythematosus (SLE) but is due to ongoing exposure to a drug

  • Drug-induced lupus resolves when the offending drug is discontinued

  • The sex ratio is nearly equal

  • Incidence of drug-induced lupus

    • 5–8% in patients taking hydralazine for a year or longer

    • < 1% for most other medications

Clinical Findings

  • Fever

  • Arthralgia

  • Myalgia

  • Serositis

  • Unlike in SLE, renal involvement and neurologic symptoms do not occur in drug-induced lupus

Diagnosis

  • Serologic testing reveals elevated titers of antinuclear antibodies in all patients, but antibodies to DNA, Sm, RNP, SS-A, and SS-B are rare (Table 20–7)

  • Antibodies to histones are common but also are seen in SLE and thus do not distinguish drug-induced lupus from SLE

  • Complement levels are usually normal

  • eTable 20–2 outlines medications associated with SLE

Table 20–7.Frequency (%) of autoantibodies in rheumatic diseases.1
eTable 20–2.Medications associated with lupus erythematosus.

Treatment

  • Discontinue the offending drug

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