Edit concept Question Editor Create issue ticket

Drug-Induced Lupus Erythematosus

DILE


Presentation

  • 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]
Intravenous Administration
  • The patient awoke after the intravenous administration of dextrose. Sensitivity to exogenous insulin was normal or increased.[ncbi.nlm.nih.gov]
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]

Workup

  • […] 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.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]

Treatment

  • 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]

Prognosis

  • 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]
  • Outlook (Prognosis) Most of the time, drug-induced lupus erythematosus is not as severe as SLE. The symptoms often go away within a few days to weeks after stopping the medicine you were taking.[mclarenhealthplan.org]
  • 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]

Etiology

  • When confronted with sterile exudative effusions, clinicians should strongly consider non-infectious etiologies.[ncbi.nlm.nih.gov]
  • Use Additional Use Additional Help Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology.[icd10data.com]
  • […] 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]
  • Etiology: Numerous drugs have been implicated in causing drug-induced lupus (Table 11).[rheumaknowledgy.com]

Epidemiology

  • 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]
  • The epidemiology and clinical course of SLE and DIL differ markedly. Prognosis is generally favourable in the latter with resolution of the symptoms within weeks once the offending drug has been withdrawn [ 7, 8 ].[omicsonline.org]
  • Epidemiology Sex : (10:1) ; more than 90% of cases reported in women Peak incidence : women aged 20–40 years ; no particular age of manifestation in men US prevalence : highest in African-American, Hispanic, and Asian populations References: [1] Epidemiological[amboss.com]
  • Epidemiología – Epidemiology is the study and analysis of the patterns, causes, and effects of health and disease conditions in defined populations.[wikivisually.com]
Sex distribution
Age distribution

Pathophysiology

  • 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.com]

Prevention

  • 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]
  • Pericarditis Nephritis When to Contact a Medical Professional Call your health care provider if: You develop new symptoms on any of the medicines listed above Your symptoms do not get better after you stop taking the medicine that caused the condition Prevention[lutheranhealthcare.org]
  • Prevention Watch for signs of a reaction if you are taking any of the drugs that can cause this problem. References Dooley MA. Drug-induced lupus. In: Tsokos GC, ed. Systemic Lupus Erythematosus. Philadelphia, PA: Elsevier; 2016:chap 54. Habif TP.[mclarenhealthplan.org]

Ask Question

5000 Characters left Format the text using: # Heading, **bold**, _italic_. HTML code is not allowed.
By publishing this question you agree to the TOS and Privacy policy.
• Use a precise title for your question.
• Ask a specific question and provide age, sex, symptoms, type and duration of treatment.
• Respect your own and other people's privacy, never post full names or contact information.
• Inappropriate questions will be deleted.
• In urgent cases contact a physician, visit a hospital or call an emergency service!