Drug-induced lupus erythematosus (patient information)

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 * Associate Editor-In-Chief: Jinhui Wu, MD; Ujjwal Rastogi, MBBS [mailto:urastogi@perfuse.org]

Overview
Drug-induced lupus erythematosus is a side-effect of long-term use of certain medications. The most commom medications that cause drug-induced lupus erythematosus are procainamide, hydralazine and quinidine. Symptoms of drug-induced lupus erythematosus are similar to systemic lupus erythematosus. After stopping the medication that caused the condition, most patients may recover.

What are the symptoms of Drug-induced lupus erythematosus?
Symptoms of drug-induced lupus erythematosus always occur after taking the drug for at least 3 to 6 months. Common symptoms are similar to systemic lupus erythemathosus.
 * Fatigue and weakness
 * Low fever
 * Muscle pain
 * Joint pain
 * Loss of appetite
 * Facial butterfly rash
 * Sensitivity to sunlight
 * Chest pain
 * Swollen lymph nodes

What causes Drug-induced lupus erythematosus?
Drug-induced lupus erythematosus is caused by a hypersensitivity reaction to a medication. Several following medications are known to cause drug-induced lupus:
 * Procainamide
 * Hydralazine
 * Quinidine
 * Chlorpromazine
 * Isoniazid
 * Methyldopa
 * Penicillamine
 * Sulfasalazine

Who is at highest risk?
The major risk factor for developing drug-induced lupus is chronic, long-term use of a drug known to cause Drug induced lupus.

Diagnosis
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:


 * Antihistone antibody
 * Antinuclear antibody (ANA) panel
 * Lupus erythematosus cell test (rarely used)

A chest x-ray may show signs of pleuritis or pericarditis. An ECG may show that the heart is affected.

Treatment options
Generally, symptoms of drug-induced lupus erythematosus may disappear within several days to weeks after stopping the medication that caused the condition.
 * Stop the medications that caused the problem.
 * Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs may be used to control inflammation and pain in patients with pain and other symptoms. Usual drugs include ibuprofen, naproxen and indomethacin. Usual side effects are pain, bleeding and ulcers in upper gastrointestinal tract.
 * Corticosteroids: Corticosteroids can be used to control many symptoms such as pain and rash. Side effects of corticosteroids may include a decreased ability against infection, worse healing in the wound and osteoporosis.
 * Antimalarial drugs: These drugs can be used to treat rash and arthritis in patients with drug-induced lupus erythematosus.

Where to find medical care for Drug-induced lupus erythematosus?
Directions to Hospitals Treating Drug-induced lupus erythematosus

What to expect (Outlook/Prognosis)?
Prognosis of drug-induced lupus erythematosus is better than systemic lupus erythemathosus. Symptoms usually disappear within several days to weeks after stopping the medication that caused the condition.

Possible complications

 * Infection
 * Thrombocytopenia purpura -- bleeding near the skin surface, resulting from a low number of platelets in the blood
 * Hemolytic anemia
 * Myocarditis
 * Percarditis