We present a case of DILE presenting with cardiac tamponade associated with infliximab use that resolved with discontinuation of the medication and administration of high-dose steroids. [ncbi.nlm.nih.gov]

CASE REPORT Case 1: A 54-year-old male patient with hypertension, taking hydralazine for four years, had been presenting with been presenting erythematous, scaly and edematous papules on the trunk, back, upper limbs and sun-exposed areas for the last [scielo.br]

• Inguinal Lymphadenopathy

  A computed tomography (CT) scan of the chest, abdomen, and pelvis showed diffuse mediastinal, supraclavicular, and inguinal lymphadenopathy. A biopsy of an inguinal lymph node showed reactive lymphoid hyperplasia. [cureus.com]

• Follicular Hyperkeratosis

  Histopathology: follicular hyperkeratosis, vacuolization of the basal layer of the epidermal and follicular epithelium, superficial perivascular mononuclear infi ltrate and melanophages in the papillary dermis DISCUSSION Drugs associated with induction [scielo.br]

• Quickening

  Non-steroidal anti-inflammatory drugs (NSAIDs) will quicken the healing process. Corticosteroids may be used if more severe symptoms of DIL are present. [en.wikipedia.org]

• Incontinence

  Histopathology: hyperkeratosis, thinning of the epidermis, vacuolar degeneration of the basal layer (A – white arrow), keratinocyte apoptosis, pigmentary incontinence, perivascular and periadnexal infi ltrate. [scielo.br]

  Histopathology: hyperkeratosis, thinning of the epidermis, vacuolar degeneration of the basal layer (A - white arrow), keratinocyte apoptosis, pigmentary incontinence, perivascular and periadnexal infi ltrate. [ncbi.nlm.nih.gov]

[…] of patients on hydralazine therapy have a positive ANA yet do not have SLE. 20 On the other hand, in patients who report common symptoms while receiving hydralazine, close monitoring and subsequent ANA levels plus antihistone antibodies and other lab workup [consultant360.com]

Associated with antiphospholipid antibodies (cerebrovascular disease, seizures, chorea) and NMDA-receptor antibodies (neurocognitive defects). [2,11] Treatment - workup and treatment should be similar to that in non-SLE patients presenting with the same [straighthealthcare.com]

SLE: Joint radiography Chest radiography and chest CT scanning Echocardiography Brain MRI/MRA Cardiac MRI Procedures Procedures that may be performed in patients with suspected SLE include the following: Arthrocentesis Lumbar puncture Renal biopsy See Workup [emedicine.medscape.com]

• Glucose Decreased

  Reactive hypoglycemia was confirmed by an oral glucose tolerance test, in which plasma glucose decreased from a fasting level of 87 mg/dL to 32 mg/dL at 3 hours and 23 mg/dL at 4 hours, the last value being associated with loss of consciousness. [ncbi.nlm.nih.gov]

• Staphylococcus Aureus

  We report the first case of DIL secondary to nafcillin administration in a patient with a prosthetic aortic valve and methicillin-sensitive Staphylococcus aureus who developed a facial rash and lower back pain. [ncbi.nlm.nih.gov]

• HLA-DR4

  These patients include those with the HLA-DR4 or HLA-DR0301 genes, the complement C4 null allele, and females. [the-hospitalist.org]

  Hydralazine: 5–8%; for slow acetylators and HLA -DR4 then 10% risk; high risk but rarely prescribed now. Quinidine: moderate risk (< 1%) Isoniazid: low risk Minocycline : relates to a prolonged course and cumulative dose; low risk. [dermnetnz.org]

  […] classes have been implicated in causing lupus. 1,3 DILE is estimated to affect 15,000 to 20,000 individuals each year and accounts for 10% of SLE cases. 1,2 Risk factors for DILE include being a slow acetylator, having certain serologic features (eg, HLA-DR4 [pharmacytimes.com]

  For example, the risk factors for DILE are higher in slow acetylators with a genetic deficiency of N-acetyltransferase, and there appears to be increased frequency of certain serologic features including human leukocyte antigen (HLA)-B8, HLA-DR4, HLA [rheumatologyadvisor.com]

  Only HLA- DR4 has been suggested to be linked with hydralazine-induced lupus. Pathology: CNS and renal findings are rare in drug-induced lupus. [rheumaknowledgy.com]

Herein we report the first case of DILE in a 68-year-old woman who presented with arthralgia, myalgia and prolonged thrombocytopenia after receiving capecitabine and bevacizumab combination treatment as palliative treatment for metastatic colon cancer [ncbi.nlm.nih.gov]

Clinical results have been published more fully by McEntegert et al. 12 Table 1 Proportion of patients continuing treatment over the five years DRUG TOXICITY Side effects were common, although not all resulted in withdrawal from treatment (table 2 ). [ard.bmj.com]

Prognosis Special patient groups [amboss.com]

Outlook (Prognosis) Most of the time, drug-induced lupus erythematosus is as severe as SLE. The symptoms often go away within a few days to weeks after stopping the medicine you were taking. Avoid taking the drug that caused the reaction in future. [lutheranhealthcare.org]

Prognosis The prognosis has improved with earlier recognition and improved management. The five-year survival rate is over 90%. [patient.info]

Prognosis and Patient Counseling. Prognosis for drug-induced lupus is good. Symptoms usually will resolve with days or weeks of discontinuation of the medication. Antibodies may persist for longer periods. VI. Patient Safety and Quality Measures A. [clinicaladvisor.com]

Use Additional Use Additional Help Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10data.com]

When confronted with sterile exudative effusions, clinicians should strongly consider non-infectious etiologies. [ncbi.nlm.nih.gov]

[…] individuals display all of these problems Chronic, relapsing, inflammatory, and often febrile multisystemic disorder of connective tissue, characterized principally by involvement of the skin, joints, kidneys, and serosal membranes; it is of unknown etiology [icd9data.com]

The exact cause is still unknown, but a genetic predisposition, as well as hormonal and immunological influences, are considered likely etiological factors. [amboss.com]

] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]

Lopez P, Mozo Gutierrez C, Suarez A (2003) Epidemiology of systemic lupus erythematosus in a northern Spanish population: gender and age influence on immunological features. [link.springer.com]

Furthermore, DILE can be differentiated from SLE by epidemiological factors. SLE tends to occur in young African-American females, while DILE is most commonly a disease of elderly Caucasians with no sexual predilection. [ncbi.nlm.nih.gov]

Epidemiología – Epidemiology is the study and analysis of the patterns, causes, and effects of health and disease conditions in defined populations. [wikivisually.com]

[…] erythematosus (SLE) is a systemic autoimmune disease characterized by acute flares, commonly presenting with rash, joint pain, and fever multiple organ systems are involved, including renal, neurologic, dermatologic, cardiovascular, and hematologic Epidemiology [medbullets.com]

Pathophysiology The pathophysiology of DILE is not well known. [ncbi.nlm.nih.gov]

Additional research efforts are necessary to get a better understanding of the pathophysiology and pharmacogenetics of DILE. follow @RheumAdvisor References Ho CH, Chauhan K. Lupus erythematosus, drug-induced. StatPearls [Internet]. [rheumatologyadvisor.com]

TNF α) (etanercept, infliximab, adalimubab) 13 Valproate Voriconazole Drugs that cause flares of SLE are as follows: Cimetidine Hydralazine Hydrochlorothiazide Mesantoin P -Aminobenzoic acid (PABA) Penicillin Phenylbutazone Sulfonamides Terbinafine 14 Pathophysiology [oralmaxillo-facialsurgery.blogspot.com]

SUMMARY OF KEY PARAMETERS OF SYSTEMIC LUPUS ERYTHEMATOSUS MARKET, THROUGH 2018 CHAPTER 3 - OVERVIEW SIGNS AND SYMPTOMS TYPES OF LUPUS SYSTEMIC LUPUS ERYTHEMATOSUS (SLE) CUTANEOUS LUPUS ERYTHEMATOSUS (CLE) DRUG-INDUCED LUPUS NEONATAL LUPUS ERYTHEMATOSUS PATHOPHYSIOLOGY [gii.co.jp]

See also the following Medscape articles: Pathophysiology SLE is an autoimmune disorder characterized by multisystem inflammation with the generation of autoantibodies. [emedicine.medscape.com]

The goals of the treatment plan are to Prevent flares Treat flares when they occur Reduce organ damage and other problems Treatments may include drugs to Reduce swelling and pain Prevent or reduce flares Help the immune system Reduce or prevent damage [icdlist.com]

List Of Drugs And Associated Risk Of Drug Induced Lupus Antiarrhythmics Drugs to prevent harmful heart arrhythmias Procainamide (Pronestyl). Risk: high Quinidine (Quinaglute). Risk: moderate Disopyramide (Norpace). [womens-health-advice.com]

Moreover, the effect seemed independent of immune suppression, implying that Plaquenil can directly act to prevent the blood clots. [medicinenet.com]

Can lupus be prevented or avoided? You cannot avoid lupus since the cause of it is unknown. However, you may be able to help prevent flares. [familydoctor.org]

Taking medicine to help prevent osteoporosis caused by corticosteroids. Preventing plaque in the arteries (atherosclerosis) that can be made worse by corticosteroids. [northshore.org]