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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

  • Symptomatic during exposure to offending drug; symptoms resolve when drug is stopped

  • Elevated ANA but unlikely to have anti-DNA antibodies unless secondary to TNF inhibitors

  • The sex ratio is nearly equal

  • Incidence of drug-induced lupus

    • 5–8% in patients taking hydralazine for ≥ 1 year

    • < 1% for most other medications

Clinical Findings

  • Fever

  • Arthralgia

  • Myalgia

  • Serositis

  • Unlike in SLE, renal involvement and neurologic symptoms are unlikely


  • 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; their absence, however, makes either diagnosis unlikely

  • Complement levels are usually normal

Table 20–7.Frequency (%) of autoantibodies in rheumatic diseases.1


  • Discontinue the offending drug

  • Drug-induced lupus generally resolves within weeks to months after drug discontinuation

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