A syndrome similar to systemic lupus erythematosus may occur in patients treated with certain drugs, Stopping the drugs will usually reverse the syndrome.
Many drugs (over 80) have been implicated, including:
(1) procainamide
(2) hydralazine
(3) minocycline
(4) diltiazem
(5) amiodarone
(6) etanercept
(7) sulfasalazine
(8) isoniazid
(9) zafirlukast
Clinical findings:
(1) pleurisy
(2) arthritis
(3) photosensitivity
(4) skin rash
(5) fever
(6) myalgias
(7) hepatosplenomegaly
(8) mouth sores
(9) fatigue
Features:
(1) The onset of symptoms occurs after starting the implicated drug.
(2) The person recovers after stopping the implicated drug.
(3) ANA testing usually shows a diffuse, homogeneous pattern due to anti-histone antibodies. Some patients have antibodies to double stranded DNA or may be negative.
(4) Serum complement levels are normal.
(5) Disease recurrence following drug rechallenge would further support the diagnosis, but this is rarely considered justified.
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