Drug-induced Lupus

Aka: Drug-induced Lupus, Systemic Lupus Secondary to Medication, Medication Causes of Systemic Lupus Erythematosus, Lupus-Like Syndrome

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II. Causes

  1. More than 80 drugs associated (first described in 1945 related to Sulfadiazine)
  2. Hydralazine (most common cause)
  3. Procainamide
  4. Isoniazid
  5. Minocycline
  6. Terbinafine
  7. Phenytoin (Dilantin)
  8. Ethosuximide
  9. D-Penicillamine
  10. Proton Pump Inhibitors
  11. Beta Blockers

III. Symptoms (following causative medication use)

  1. See Systemic Lupus Erythematosus
  2. Arthralgias
  3. Rash
  4. Serositis
  5. Hematologic abnormalities

IV. Labs

  1. Screening indicated for causative medication use and symptoms suggestive of SLE (see above)
    1. ANA Titer
  2. Confirmatory testing if positive ANA titer
    1. Antihistone Antibody
      1. Test Sensitivity in drug induced lupus: 95%
      2. Test Specificity in drug induced lupus: >90%

V. Prognosis

  1. Symptoms often recede with stopping causative agent
  2. Rarely life threatening

VI. References

  1. Ali (2018) Am Fam Physician 98(3): 164-70 [PubMed]
  2. Antonov (2004) Clin Dermatol 22(2): 157-66 [PubMed]

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