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.
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 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.
Complications
Infection
Thrombocytopenia purpura -- bleeding near the skin surface, resulting from a low number of platelets in the blood
Call for an appointment with your health care provider if:
Your symptoms do not improve after you stop taking the medication that caused the condition
You develop new symptoms
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.
Review Date:
6/28/2011
Reviewed By:
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.
