Drug-induced lupus
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Occasionally, medications can cause a syndrome of symptoms very similar to SLE. This is
called drug-induced lupus. Medications that may cause this syndrome include hydralazine
(used for high blood pressure) and procainamide (used for abnormal heartbeats).
Drug-induced lupus almost always disappears after the patient stops taking the medications
that caused it.
Causes of Drug-induced lupus
Drug-induced lupus erythematosus occurs as a result of a hypersensitivity reaction to a
medication. The drug may react with cell materials, causing the body to react to itself
and form antinuclear antibodies.
Drugs that are known to cause this type of reaction in some people include:
procainamide, isoniazid, chlorpromazine, penicillamine, sulfasalazine, hydralazine,
methyldopa, and quinidine. Symptoms tend to occur after taking the drug for a reasonable
period of time, usually at least 3 to 6 months.
In drug-induced lupus erythematosus, the features of arthritis, systemic symptoms, and
cardiac and pulmonary (lung) symptoms may be present. Other symptoms associated with SLE,
such as lupus nephritis and neurological disease, are rare.
Drug-induced lupus erythematosus also differs from SLE in that the course of the
disease is usually not as severe as SLE. Usually, the symptoms resolve within a few days
to weeks after stopping the medication. The sex distribution of drug-induced lupus
erythematosus is equal, whereas in SLE, women are affected more often than men.
Treatment of Drug-induced lupus
Usually, symptoms resolve within several days to weeks after
stopping the medication that caused the symptoms. Nonsteroidal anti-inflammatory
medications are used to treat arthritis and pleurisy.
Corticosteroid creams are used to treat skin rashes. Antimalarial drugs
(hydroxychloroquine) are sometimes used for skin and arthritis symptoms. Sensitivity to
light is treated by protective clothing, sunglasses, and sunscreen. Routine eye
examinations are recommended to detect eye complications early.
Occasionally, the steroid prednisone is used to treat more severe cases, especially if
the heart is involved. Very rarely, severe drug-induced lupus with severe cardiac
involvement or significant kidney or neurologic disease requires high doses of steroids
and strong medications that suppress the immune system, such as azathioprine or
cyclophosphamide. |
