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 [doi.org]

• Weight Loss

  These symptoms include fever, malaise, weight loss, arthritis, arthralgia and myalgia 3. Symptoms generally worsen the longer the patient is maintained on the suspect medicine 3. [medsafe.govt.nz]

  Stymptoms may include, fever, loss of appetite, malaise, weight loss, skin rash, joint pain and swelling, blurred vision, and chest pain. [ozarkderm.com]

  They may include: Muscle pain Joint pain, sometimes with swelling Fever Tired feeling Weight loss Inflammation around the lungs or heart that causes pain or discomfort You may feel these as soon as 3 weeks after you start taking the drug. [webmd.com]

  She reports significant weight loss despite eating a normal diet. She reports that she sunburns very easily and has a facial rash that is hard to cover with makeup. [medbullets.com]

  Symptoms Blurred vision Fever General ill feeling (malaise) Joint pain Joint swelling Loss of appetite Pleuritic chest pain Skin rash Gets worse with sunlight "Butterfly" rash across bridge of nose and cheeks Weight loss Exams and Tests The health care [lutheranhealthcare.org]

• Anorexia

  DILE symptoms include anorexia, arthralgia, fever, lymphadenopathy, malaise, myalgia, rash, serositis, and weight loss.5 The rash usually presents as polycyclic, with scaling and erythema in sun-exposed areas. [the-hospitalist.org]

  Cardinal Findings: Most patients present with insidious onset of constitutional features (e.g., low-grade fever, fatigue, anorexia, weight loss, arthralgias, or myalgias). [rheumaknowledgy.com]

  Clinical Presentation Hydralazine-induced lupus is characterized by onset of any or all of the following symptoms: arthralgia, fever, chest pain, anorexia, fatigue, petechiae, rash, joint pain and swelling, anemia, abnormal complete blood count, leukopenia [consultant360.com]

  Bone marrow suppression, dysgeusia, anorexia, vomiting and diarrhea are the most common side effects and it is very similar chemically to the α-amino acid cysteine, but with geminal methyl groups α to the thiol group. [wikivisually.com]

  Musculo skeletal symptoms frequently accompanied by constitutional symptoms such as fever, malaise, fatigue, anorexia or weight loss. Liver involvement in 31 patients. 12 patients with dermatological manifestations. [doi.org]

• Cough

  She was admitted to our hospital in July 1990, complaining of productive cough and general fatigue. [doi.org]

  Symptoms of infection may sometimes be similar to a flare up of lupus and include: high temperature (fever) of 38C (100.4F) or above new onset of cough, phlegm or breathlessness burning on passing urine or blood in the urine (haematuria) diarrhoea You [your.md]

  The chest pain is aggravated by coughing, deep breathing, and certain changes in body position. The heart muscle itself rarely can become inflamed ( carditis ). [rxlist.com]

• Tachycardia

  This results in a disturbance in the membrane potential and leads to a supraventricular tachycardia which induces failure of the pacemaker. [wikivisually.com]

• Osteoporosis

  Your doctor may also prescribe bisphosphonates, a type of medicine that is also used for the prevention and treatment of osteoporosis. To learn more, see the topic Osteoporosis. Lupus treatment is complicated by several things. [northshore.org]

  Have tests to screen for thinning of the bones (osteoporosis). Avoid tobacco and drink minimal amounts of alcohol. The outcome for people with SLE has improved in recent years. Many people with SLE have mild symptoms. [nlm.nih.gov]

  Effects of Omega-3 Fatty Acids on Lipids and Glycemic Control in Type II Diabetes and the Metabolic Syndrome and on Inflammatory Bowel Disease, Rheumatoid Arthritis, Renal Disease, Systemic Lupus Erythematosus, and Osteoporosis. [passeportsante.net]

  Patients with SLE are also at increased risk of certain other comorbidities, including atherosclerosis, hypertension, dyslipidaemias, diabetes, osteoporosis, avascular necrosis and malignancies (especially non-Hodgkin's lymphoma ). [ 9 ] Management Patients [patient.info]

  […] patients presenting with the same conditions [11] Other related conditions Antiphospholipid antibody syndrome - occurs in 10 - 15% of SLE patients; associated with hypercoagulable state, accelerated atherosclerosis, and pulmonary hypertension [1,21] Osteoporosis [straighthealthcare.com]

• Morning Stiffness

  Full blood count, erythrocyte sedimentation rate, C reactive protein, biochemistry were performed at each visit with measurements of Ritchie articular index, pain score on 10 cm visual analogue scale and morning stiffness. [ard.bmj.com]

  stiffness朝のこわばり n necrotizing angiitis壊死性血管炎 neovascularization新生血管形成 nodule小［結］節 nonsteroidal anti-inflammatory drugs (NSAIDs)非ステロイド性抗炎症剤 o oligosialia唾液減少［症］ osteoarthritis (OA)変形性関節症 overlap syndrome重複（オーバーラップ）症候群〈膠原病の〉 p pancreas膵臓、膵 peak [expiratory [tokyo-med.ac.jp]

  stiffness, and myalgia. 23,26-27 Raynaud’s disease and mouth ulcers have also been reported. 23 There are contrasts in the presentation of the clinical signs and symptoms of DIL due to minocycline. [uspharmacist.com]

  Arthralgia: Joint and muscle pains are common, often with early morning stiffness. Joint swelling is unusual and the arthritis is usually non-erosive. [patient.info]

  Morning stiffness may also be felt. Lupus arthritis often occurs on both sides of the body at the same time. It's most often felt in the wrists, the small joints of the hands, and the elbows, knees, and ankles. [northshore.org]

• Skin Lesion

  The cutaneous features of drug-induced SLE are protean, including particularly purpura, erythema nodosum and photosensitivity as well as the skin lesions characterizing both urticarial and necrotizing vasculitis. [ncbi.nlm.nih.gov]

  There was rapid improvement of skin lesions, and resolution of symptoms after 4 weeks ( Figure 3 ). FIGURE 1 Drug-induced lupus by hydralazine. [doi.org]

  […] rash or skin lesions. [uspharmacist.com]

• Acne Vulgaris

  Abstract An 18-year-old Japanese girl had received oral minocycline 200mg daily for treatment of acne vulgaris since 16 years old. [ncbi.nlm.nih.gov]

  David Phizackerley, deputy editor, Drug and Therapeutics Bulletin 1 1 BMJ Journals, BMA House, London WC1H 9JR, UK dphizackerley{at}bmj.com In their clinical review of acne vulgaris, Dawson and Dellavalle discuss the use of oral antibiotics. 1 Although [bmj.com]

  This situation reflects the pattern of long-term use in the treatment of acne vulgaris and may also help explain the sole association of minocycline with drug-induced lupus. [aafp.org]

  Perinuclear antineutrophilic cytoplasmatic antibody-positive cutaneous polyarteritis nodosa associated with minocycline therapy for acne vulgaris. J Am Acad Dermatol 2001 ; 44: 198 – 206. [doi.org]

  Margolis DJ, Hoffstad O, Bilker W (2007) Association or lack association between tetracycline class antibiotics used for acne vulgaris and lupus erythematosus. [link.springer.com]

Systemic Lupus Erythematosus (SLE) Workup. (19 September 2016 updated.) Available online at http://emedicine.medscape.com/article/332244-workup. Accessed March 27, 2017. Fonti utilizzate nelle precedenti revisioni (2003 August). [labtestsonline.it]

[…] 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]

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]

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

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]

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]

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]

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

[…] 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.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]

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]

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]

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