Drug-induced lupus erythematosus
Drug-induced lupus erythematosus is an autoimmune disorder
that is brought on by a reaction to medication.
See also: Systemic lupus erythematosus (SLE)
Alternative Names
Lupus - drug induced
Causes, incidence, and risk factors
Drug-induced lupus erythematosus is similar to systemic lupus erythematosus
(SLE). It is an autoimmune disorder, which means the body mistakenly attacks healthy tissue. It is caused by a hypersensitivity reaction
to a medication.
The most common medications known to cause drug-induced lupus include: isoniazid, hydralazine, and procainamide. Other medications known to cause drug-induced lupus, include:
- Anti-seizure medications
- Capoten
- Chlorpromazine
- Etanercept
- Infliximab
- Methyldopa
- Minocycline
- Penicillamine
- Quinidine
- Sulfasalazine
Symptoms tend to occur after taking the drug for at least 3 to 6 months.
Persons with drug-induced lupus erythematosus may have symptoms that affect the joints (arthritis
), heart, and lungs. Other symptoms associated with SLE, such as lupus nephritis
and nervous system (neurological) disease, are rare.
Signs and tests
The health care provider will listen to your chest with a stethoscope. The doctor may hear a sound called a heart friction rub or pleural friction rub. There may be signs of pericarditis
.
A skin exam shows a rash.
Tests that may be done include:
A chest x-ray
may show signs of pleuritis or pericarditis. An ECG
may show that the heart is affected.
Treatment
Usually, symptoms go away within several days to weeks after stopping the medication that caused the condition.
Treatment may include:
-
Nonsteroidal anti-inflammatory drugs (NSAIDs) to treat arthritis and pleurisy
-
Corticosteroid creams to treat skin rashes
-
Antimalarial drugs (hydroxychloroquine) to treat skin and arthritis symptoms
Very rarely, high doses of corticosteroids (prednisone, methylprednisolone) and immune system suppressants (azathioprine or cyclophosphamide) are used to treat persons with severe drug-induced lupus that affects the heart, kidney, and neurological system.
Protective clothing, sunglasses, and sunscreen are recommended.
Expectations (prognosis)
Drug-induced lupus erythematosus is usually not as severe as SLE. Usually, the symptoms go away within a few days to weeks after stopping the medication.
You should avoid the medication in the future, or symptoms usually return. Routine eye exams are recommended to detect eye complications early.
Calling your health care provider
Call for an appointment with your health care provider if:
Prevention
Be aware of the risk when taking medications that are known to cause this reaction. If symptoms begin to appear, contact your doctor.
References
Wright B, Bharadwaj S, Abelson A. Systemic Lupus Erythematosus. In: Carey WD, ed. Cleveland Clinic: Current Clinical Medicine 2nd ed. Philadelphia, Pa: Saunders Elsevier; 2010.
Updated: 6/28/2011
Ariel D. Teitel, M.D., M.B.A., Chief, Division of Rheumatology, St. Vincent’s Hospital, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.