The management of a patient with drug-induced lupus is determined by the clinical signs and symptoms.
Patient selection: Development of a positive ANA during drug therapy
If the patient is asymptomatic, then drug therapy can be continued.
If the patient develops symptoms, then the drug should be stopped permanently.
Signs and Symptoms
Management
mild constitutional and/or musculoskeletal
none or aspirin/NSAIDS
skin with joint manifestations
hydroxychloroquine po
pleurisy, nephritis, pericarditis, or other severe condition
short-term low-dose corticosteroids
where:
• Constitutional symptoms include low grade fever, malaise, and/or fatigue.
With drug-induced lupus, both the positive ANA and any clinical symptoms will revert if the drug is discontinued, although it may take several months (up to 2 years).
Differential diagnosis: Systemic lupus erythematosus, with onset during the drug therapy.
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