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Chinnusamy M, Viswanathan RA, Janakiraman S, Elayidath R. Drug-Induced Lupus Erythematosus Associated with Proton Pump Inhibitor. JOURNAL OF HEALTH AND ALLIED SCIENCES NU 2020. [DOI: 10.1055/s-0040-1716601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
AbstractDrug-induced lupus erythematosus is an autoimmune phenomenon where the drug exposure leads to the development of systemic lupus erythematous like clinical features. Drug-induced lupus erythematosus can be divided into systemic lupus erythematous, subacute cutaneous lupus erythematous, and chronic cutaneous lupus erythematous. Here, we report a case of a 29-year-old female presented with systemic lupus erythematous due to chronic use of proton pump inhibitors, which is considered to be very rare.
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Affiliation(s)
- Manokaran Chinnusamy
- Department of General Medicine, Sri Manakula Vinayagar Medical College and Hospital, Madagadipet, Pondicherry, India
| | - Ram Arvind Viswanathan
- Department of General Medicine, Sri Manakula Vinayagar Medical College and Hospital, Madagadipet, Pondicherry, India
| | - Sathiyanarayanan Janakiraman
- Department of General Medicine, Sri Manakula Vinayagar Medical College and Hospital, Madagadipet, Pondicherry, India
| | - Roshna Elayidath
- Department of General Medicine, Sri Manakula Vinayagar Medical College and Hospital, Madagadipet, Pondicherry, India
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Sosenko T, Pasula S, Brahmamdam R, Girnita D. When Chest Pain Reveals More: A Case of Hydrochlorothiazide-Induced Systemic Lupus Erythematosus. AMERICAN JOURNAL OF CASE REPORTS 2019; 20:26-30. [PMID: 30613100 PMCID: PMC6396705 DOI: 10.12659/ajcr.911380] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Accepted: 09/20/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Drug induced lupus erythematosus is considered an autoimmune entity which is precipitated by medications. Hydrochlorothiazide has been recognized to cause subacute cutaneous lupus erythematosus, but very few cases of systemic drug induced lupus systemic erythematosus have been reported. CASE REPORT A 57-year-old Caucasian male with a past medical history of hypertension and hyperlipidemia presented with recurrent fevers, chest pain, and dyspnea. Initial evaluation revealed diffuse ST elevations, small pericardial effusion, anemia, and leukopenia. He was initially treated with nonsteroidal anti-inflammatory drugs and prednisone for pericarditis. Six months later, he reported fatigue, arthralgias, morning stiffness, weight loss, fevers, and night sweats. Laboratory tests revealed persistent anemia and leukopenia. Extensive workup, including bone marrow biopsy and infectious evaluations, was negative. Autoimmune workup, however, revealed positive antihistone and antichromatin antibodies despite negative antinuclear antibody. A diagnosis of drug induced lupus secondary to hydrochlorothiazide was made. The medication was stopped, and prednisone was initiated resulting in marked improvement in his symptoms and hematologic abnormalities. CONCLUSIONS This report is one of the few known cases of systemic lupus erythematosus most likely induced by hydrochlorothiazide. Based on our finding, hydrochlorothiazide should be considered a possible offending agent when a patient presents with symptoms suspicious of drug induced lupus.
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The Modified Vaccination Technique. Vaccines (Basel) 2018; 7:vaccines7010001. [PMID: 30577575 PMCID: PMC6466438 DOI: 10.3390/vaccines7010001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 12/13/2018] [Accepted: 12/19/2018] [Indexed: 11/16/2022] Open
Abstract
In addition to active and passive immunizations, there is a third method of immunization, the modified vaccination technique, which is based on injecting a combination of target antigens and antibodies against this antigen. The vaccine is essentially comprised of immune complexes with pre-determined immune-inducing components. When such an immune complex (target antigen × antibody against the target antigen) with a slight antigen excess is administered, it evokes a corrective immune response by the production of the same antibody with the same specificity against the target antigen that is present in the immune complex (pre-determined immune response).
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Batra J, Kaur S, Kaushal S, Singh A. Lamotrigine-induced Systemic Lupus Erythematosus: A Diagnostic Dilemma. Indian Dermatol Online J 2018; 9:445-447. [PMID: 30505789 PMCID: PMC6232978 DOI: 10.4103/idoj.idoj_24_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Many drugs are known to cause systemic lupus erythematosus (SLE), however there are no well defined criteria for drug induced lupus erythematosus (DILE). We present a rare case of lamotrigine induced lupus presenting as acute syndrome of apoptotic pan epidermolysis (ASAP).
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Affiliation(s)
- Jaskaran Batra
- Department of Dermatology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Sukhjot Kaur
- Department of Dermatology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Sandeep Kaushal
- Department of Pharmacology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Aminder Singh
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
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Szczęch J, Samotij D, Werth VP, Reich A. Trigger factors of cutaneous lupus erythematosus: a review of current literature. Lupus 2017; 26:791-807. [PMID: 28173739 DOI: 10.1177/0961203317691369] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
It is currently believed that autoimmune conditions are triggered and aggravated by a variety of environmental factors such as cigarette smoking, infections, ultraviolet light or chemicals, as well as certain medications and vaccines in genetically susceptible individuals. Recent scientific data have suggested a relevant role of these factors not only in systemic lupus erythematosus, but also in cutaneous lupus erythematosus (CLE). A variety of environmental factors have been proposed as initiators and exacerbators of this disease. In this review we focused on those with the most convincing evidence, emphasizing the role of drugs in CLE. Using a combined search strategy of the MEDLINE and CINAHL databases the following trigger factors and/or exacerbators of CLE have been identified and described: drugs, smoking, neoplasms, ultraviolet radiation and radiotherapy. In order to give a practical insight we emphasized the role of drugs from various groups and classes in CLE. We also aimed to present a short clinical profile of patients with lesions induced by various drug classes.
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Affiliation(s)
- J Szczęch
- 1 Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - D Samotij
- 1 Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - V P Werth
- 2 Corporal Michael J. Crescenz (Philadelphia) Veterans Affairs Medical Center and Department of Dermatology University of Pennsylvania School of Medicine Philadelphia, PA, USA
| | - A Reich
- 1 Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
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Gubinelli E, Cocuroccia B, Girolomoni G. Subacute Cutaneous Lupus Erythematosus Induced by Nifedipine. J Cutan Med Surg 2016. [DOI: 10.1177/120347540300700310] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Subacute cutaneous lupus erythematosus (SCLE) has been reported to be associated with the use of several drugs, including thiazides, terbinafine, and, rarely, calcium channel blockers. Objective: A case of SCLE induced by nifedipine is presented. Methods and Results: A 48-year-old white woman developed a papulosquamous and annular eruption in sun-exposed areas during the summer. The patient was taking nifedipine for essential hypertension for four years. Serology showed the presence of antinuclear and anti-Ro/SSA as well as antihistone antibodies. Histopathologic and immunopathologic (granular IgM deposits at the dermoepidermal junction) findings confirmed the diagnosis of SCLE. Nifedipine discontinuation led to rapid improvement with almost complete resolution of skin lesions in one month in the absence of active treatment. Reduction of antinuclear, anti-Ro/SSA, and antihistone antibody levels was documented after six months. Conclusion: Nifedipine can cause SCLE after a long period of administration. Antihistone antibodies may be associated with drug-induced SCLE.
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Jguirim M, Jbeli A, Brahim HB, Mhenni A, Youssef M, Touzi M, Zrour S, Bejia I, Bergaoui N. [Systemic lupus erythematosus induced by isoniazid: a rare complication to fear]. Pan Afr Med J 2015; 20:181. [PMID: 26430478 PMCID: PMC4577625 DOI: 10.11604/pamj.2015.20.181.5470] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 11/20/2014] [Indexed: 11/29/2022] Open
Abstract
Le lupus induit est défini comme un syndrome lupique généralement cutanéo-articulaire secondaire à une exposition continue à un traitement et qui disparaît après arrêt de celle-ci. Nous rapportons deux cas de lupus induit par l'isoniazide. Il s'agissait de deux femmes âgées respectivement de 30 et 35 ans. Elles présentaient un lupus induit par l'isoniazide après un et deux mois de traitement d'une tuberculose ganglionnaire. La maladie s'est manifestée par des signes articulaires, une éruption cutanée, une leucopénie et une anémie. Les anticorps antinucléaires et les anticorps antihistone étaient présents dans le sérum des deux malades. L’évolution était favorable après arrêt de l'isoniazide et une corticothérapie per os. Les médicaments antituberculeux notamment l'isoniazide sont responsables d'effets indésirables fréquents. Le lupus induit doit être évoqué lorsqu'un patient présente un tableau clinico-biologique évocateur.
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Affiliation(s)
- Mahbouba Jguirim
- Service de Rhumatologie, CHU Fattouma-Bourguiba Monastir, Tunisie
| | - Amna Jbeli
- Service de Médecine Interne, CHU Fattouma-Bourguiba Monastir, Tunisie
| | - Hajer Ben Brahim
- Service des Maladies Infectieuses, CHU Fattouma-Bourguiba Monastir, Tunisie
| | - Amira Mhenni
- Service de Rhumatologie, CHU Fattouma-Bourguiba Monastir, Tunisie
| | - Monia Youssef
- Service de Dermatologie, CHU Fattouma-Bourguiba Monastir, Tunisie
| | - Mongi Touzi
- Service de Rhumatologie, CHU Fattouma-Bourguiba Monastir, Tunisie
| | - Sawssen Zrour
- Service de Rhumatologie, CHU Fattouma-Bourguiba Monastir, Tunisie
| | - Ismail Bejia
- Service de Rhumatologie, CHU Fattouma-Bourguiba Monastir, Tunisie
| | - Naceur Bergaoui
- Service de Rhumatologie, CHU Fattouma-Bourguiba Monastir, Tunisie
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8
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Araújo-Fernández S, Ahijón-Lana M, Isenberg DA. Drug-induced lupus: Including anti-tumour necrosis factor and interferon induced. Lupus 2014; 23:545-53. [DOI: 10.1177/0961203314523871] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Drug-induced lupus erythematosus is defined as a syndrome with clinical and serological features similar to systemic lupus erythematosus that is temporally related to continuous drug exposure and which resolves after discontinuation of this drug. More than 90 drugs, including biological modulators such as tumour necrosis factor-α inhibitors and interferons, have been identified as likely ‘culprits’. While there are no standard diagnostic criteria for drug-induced lupus erythematosus, guidelines that can help to distinguish drug-induced lupus erythematosus from systemic lupus erythematosus have been proposed and several different patterns of drug-induced lupus erythematosus are emerging. Distinguishing drug-induced lupus erythematosus from systemic lupus erythematosus is important because the prognosis of drug-induced lupus erythematosus is usually good when the drug is withdrawn. This review discusses the differences between drug-induced lupus erythematosus and systemic lupus erythematosus, the mechanisms of action of drug-induced lupus erythematosus and drugs that are usually associated with drug-induced lupus erythematosus, with particular focus on the biological treatments.
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Affiliation(s)
| | - M Ahijón-Lana
- Department of Rheumatology, Hospital Ramón y Cajal, Madrid, Spain
| | - DA Isenberg
- Centre for Rheumatology, Department of Medicine, University College London Hospital, London, UK
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9
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Harnett DT, Chandra-Sekhar HB, Hamilton SF. Drug-induced lupus erythematosus presenting with cardiac tamponade: a case report and literature review. Can J Cardiol 2013; 30:247.e11-2. [PMID: 24373757 DOI: 10.1016/j.cjca.2013.11.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 11/11/2013] [Accepted: 11/11/2013] [Indexed: 12/27/2022] Open
Abstract
The presentation of drug-induced lupus erythematosus (DILE) is typically mild, with a significantly lower incidence of life-threatening end-organ dysfunction relative to idiopathic systemic lupus erythematosus. DILE is an uncommon cause of cardiac tamponade but has been reported in patients treated with procainamide, isoniazid, hydralazine, sulfasalazine, and carbamazepine. 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. In conclusion, DILE should be considered in the differential diagnosis in cases of pericarditis with cardiac tamponade without a clear cause.
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Affiliation(s)
- David T Harnett
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
| | | | - Sean F Hamilton
- St Clare's Mercy Hospital, Memorial University of Newfoundland, St John's, Newfoundland, Canada
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10
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Barabas AZ, Cole CD, Lafreniere R, Weir DM. Regaining Tolerance to a Self-antigen by the Modified Vaccination Technique. Clin Rev Allergy Immunol 2013; 45:193-201. [DOI: 10.1007/s12016-012-8350-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Kim BS, Hong YM, Park SM, Park IW, Lee BH, Jeong JH, Lee CW. A Case of Angiotensin Converting Enzyme Inhibitor-Induced Systemic Lupus Erythematosus. JOURNAL OF RHEUMATIC DISEASES 2011. [DOI: 10.4078/jrd.2011.18.4.288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Byung Seok Kim
- Department of Internal Medicine, Wallace Memorial Baptist Hospital, Busan, Korea
| | - Young Mi Hong
- Department of Internal Medicine, Wallace Memorial Baptist Hospital, Busan, Korea
| | - Seong Min Park
- Department of Internal Medicine, Wallace Memorial Baptist Hospital, Busan, Korea
| | - Il Woo Park
- Department of Internal Medicine, Wallace Memorial Baptist Hospital, Busan, Korea
| | - Byung Hee Lee
- Department of Internal Medicine, Wallace Memorial Baptist Hospital, Busan, Korea
| | - Joon Hoon Jeong
- Department of Internal Medicine, Wallace Memorial Baptist Hospital, Busan, Korea
| | - Choong Won Lee
- Department of Internal Medicine, Wallace Memorial Baptist Hospital, Busan, Korea
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14
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Application of the modified vaccination technique for the prevention and cure of chronic ailments. ASIAN PAC J TROP MED 2010. [DOI: 10.1016/s1995-7645(10)60060-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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15
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Agarwal AL, Sharma V, Biswas D. Obsessional jealousy: unusual presentation. Aust N Z J Psychiatry 2008; 42:1068. [PMID: 19016096 DOI: 10.1080/00048670802512081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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16
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Weger W, Kränke B, Gerger A, Salmhofer W, Aberer E. Occurrence of subacute cutaneous lupus erythematosus after treatment with fluorouracil and capecitabine. J Am Acad Dermatol 2008; 59:S4-6. [PMID: 18625380 DOI: 10.1016/j.jaad.2007.06.040] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2007] [Revised: 06/17/2007] [Accepted: 06/29/2007] [Indexed: 01/17/2023]
Abstract
Capecitabine, an oral fluoropyrimidine and 5-fluorouracil (FU) prodrug recently approved for the treatment of metastatic colon and breast cancer, is currently under investigation in patients with gastric cancer. It has the advantage of oral administration, and good tolerability with its activity being comparable with intravenous 5-FU. Lupus erythematosus and lupuslike drug eruptions have been observed after 5-FU treatment, but so far no cases of subacute cutaneous lupus erythematosus have been described in patients treated either with capecitabine or 5-FU. We report a patient who developed subacute cutaneous lupus erythematosus after administration of 5-FU and capecitabine.
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Affiliation(s)
- Wolfgang Weger
- Department of Dermatology, Medical University of Graz, Graz, Austria
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17
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Mor A, Pillinger MH, Wortmann RL, Mitnick HJ. Drug-induced arthritic and connective tissue disorders. Semin Arthritis Rheum 2007; 38:249-64. [PMID: 18166218 DOI: 10.1016/j.semarthrit.2007.10.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2007] [Revised: 10/01/2007] [Accepted: 10/21/2007] [Indexed: 12/15/2022]
Abstract
OBJECTIVES All pharmacologic agents have the potential for both benefit and toxicity. Among the more interesting and important adverse consequences of drug therapy are a range of joint and connective tissue complaints that may mimic or reproduce primary rheumatologic diseases. In this article, we review the literature on commonly used drugs reported to induce arthritis and/or connective tissue-based diseases. We assess the strength of the reported associations, discuss diagnostic features and treatment implications, and consider possible mechanisms for drug-induced genesis of rheumatic conditions. METHODS We reviewed the Medline database from 1987 to 2006 to identify drug-induced arthritic and connective-tissue disease syndromes, utilizing 48 search terms. A qualitative review was performed after the articles were abstracted and the relevant information was organized. RESULTS Three hundred fifty-seven articles of possible relevance were identified. Two hundred eleven publications were included in the final analysis (case series and reports, clinical trials, and reviews). Many drugs were identified as mimicking existing rheumatic conditions, including both well-established small molecules (eg, sulfasalazine) and recently introduced biologic agents (eg, antitumor necrosis factor agents). The most commonly reported drug-induced rheumatic conditions were lupus-like syndromes. Arthritis and vasculitis were also often reported. CONCLUSIONS Drug-induced rheumatic syndromes are manifold and offer the clinician an opportunity to define an illness that may remit with discontinuation of the offending agent. Early diagnosis and withdrawal of the drug may prevent unnecessary morbidity and disability.
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Affiliation(s)
- Adam Mor
- Division of Rheumatology, Department of Medicine, New York University School of Medicine, New York, NY 10003, USA.
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Abstract
Drug-induced lupus (DIL) is a rare adverse reaction to a large variety of drugs with features resembling those of idiopathic systemic lupus erythematosus (SLE). It usually develops only after months and, quite commonly, years of treatment with the offending agent, although latencies of days or weeks have been described in some instances. There are some indications that the risk of DIL can increase with higher daily and cumulative doses and with longer duration of therapy. There are no definitive and commonly accepted diagnostic criteria for DIL, but the following guidelines have been proposed: (a) sufficient and continuing exposure to a specific drug, (b) at least one symptom compatible with SLE, (c) no history suggestive of SLE before starting the drug, and (d) resolution of symptoms within weeks (sometimes months) after discontinuation of the putative offending agent. In addition, it is frequently suggested that the presence of ANA is required for the diagnosis of DIL. However, negative ANA test results should not automatically preclude such a diagnosis, particularly if a patient has other autoantibodies associated with SLE/DIL.
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Affiliation(s)
- Andrea T Borchers
- Division of Rheumatology, Allergy and Clinical Immunology, School of Medicine, University of California, Davis, California 95616, USA
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20
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Kluger N, Bessis D, Guillot B. Chronic cutaneous lupus flare induced by systemic 5-fluorouracil. J DERMATOL TREAT 2006; 17:51-3. [PMID: 16467025 DOI: 10.1080/09546630500475591] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
5-Fluorouracil is an antineoplastic antimetabolite responsible for a variety of cutaneous reactions. We report a case of chronic cutaneous lupus flare related to systemic 5-fluorouracil administration for breast cancer in a patient with documented history of chronic cutaneous lupus.
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Affiliation(s)
- N Kluger
- Department of Dermatology, Hôpital Saint Eloi, Montpellier, France
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Leydet H, Armingeat T, Pham T, Lafforgue P. [Minocycline-induced lupus-like disease]. Rev Med Interne 2005; 27:72-5. [PMID: 16236387 DOI: 10.1016/j.revmed.2005.09.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2005] [Accepted: 09/05/2005] [Indexed: 11/23/2022]
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Abstract
Among the numerous idiopathic immune-mediated diseases that can be drug-induced, such as pemphigus, psoriasis, lichen, etc, drug-induced lupus is the most widely commented upon and investigated. The terms drug-induced lupus (DIL) and drug-induced lupus erythematosus (DILE) are preferred, but other ones are also used--drug-related lupus, lupus-like syndrome, and lupus erythematosus medicamentosus. This review discusses the general issues in DILE, such as pathogenic mechanisms, clinical forms, and diagnostic criteria, and provides more detailed information for some of the implicated drugs: minocycline, statins, terbinafine, etc.
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Affiliation(s)
- Dimitar Antonov
- Department of Dermatology and Venereology, Sofia Faculty of Medicine, Sofia, Bulgaria.
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23
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Tsankov N, Broshtilova V, Kazandjieva J. Tetracyclines in dermatology. Dis Mon 2004. [DOI: 10.1016/j.disamonth.2004.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Blazes DL, Martin GJ. Drug-induced lupus erythematosus secondary to nafcillin: the first reported case. Rheumatol Int 2003; 24:242-3. [PMID: 14658003 DOI: 10.1007/s00296-003-0356-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2003] [Accepted: 06/07/2003] [Indexed: 12/01/2022]
Abstract
With an estimated incidence of 15-30,000 cases per year in the United States, drug-induced lupus erythematosus (DIL) is an uncommon iatrogenic condition. The number of implicated medications increases each year. 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.
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Affiliation(s)
- David L Blazes
- Infectious Diseases Service, National Naval Medical Center, 8901 Wisconsin Avenue, Bethesda, Maryland 20889, USA.
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Crowson AN, Brown TJ, Magro CM. Progress in the understanding of the pathology and pathogenesis of cutaneous drug eruptions : implications for management. Am J Clin Dermatol 2003; 4:407-28. [PMID: 12762833 DOI: 10.2165/00128071-200304060-00005] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Cutaneous drug eruptions are among the most common adverse reactions to drug therapy. The etiology may reflect immunologic or nonimmunologic mechanisms, the former encompassing all of the classic Gell and Combs immune mechanisms. Cumulative and synergistic effects of drugs include those interactions of pharmacokinetic and pharmacodynamic factors reflecting the alteration by one drug of the effective serum concentration of another and the functions of drugs and their metabolites that interact to evoke cutaneous and systemic adverse reactions. Recent observations include the role of concurrent infection with lymphotropic viruses and drug effects that, through the enhancement of lymphoid blast transformation and/or lymphocyte survival and the contribution of intercurrent systemic connective tissue disease syndromes, promote enhanced lymphocyte longevity and the acquisition of progressively broadening autoantibody specificities. The latter are particularly opposite to drug-induced lupus erythematosus and to drug reactions in the setting of HIV infection. Specific common types of cutaneous drug eruptions will be discussed in this review. Successful management of cutaneous drug eruptions relies upon the prompt discontinuation of the causative medication; most drug eruptions have a good prognosis after this is accomplished. Oral or topical corticosteroids can be administered to aid in the resolution of some types of eruptions. Antihistamines or anti-inflammatory agents may also be administered for some eruptions.
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Affiliation(s)
- A Neil Crowson
- University of Oklahoma and Regional Medical Laboratories, Tulsa, Oklahoma, USA.
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Funauchi M, Yamagata T, Nozaki Y, Sugiyama M, Ikoma SY, Kinoshita K, Kanamaru A. A case of systemic lupus erythematosus that manifested in the course of schizophrenia. Scand J Rheumatol 2003; 31:374-6. [PMID: 12492255 DOI: 10.1080/030097402320817121] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
A case of schizophrenia is presented in which SLE was diagnosed after 14-year duration. Antibodies to single and double-stranded DNAs, but not to histone. were detected. This case suggests that similar immunological abnormalities as SLE are associated with the pathogenesis of a group of schizophrenia and that class-switch of anti-dsDNA antibodies are important in the pathogenesis of SLE.
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Affiliation(s)
- Masunori Funauchi
- Department of Hematology, Nephrology and Rheumatology, Kinki University School of Medicine, Osaka-Sayama, Osaka, Japan.
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Abstract
Rheumatic syndromes related to drug therapies have been described for decades. The introduction of many new therapeutic agents in recent years has been accompanied by an increase in such reported associations. By definition, drug-induced syndromes are temporally related to starting a drug, and the symptoms and signs generally regress with its discontinuation. The classic and still most common cases resemble systemic lupus erythematosus or scleroderma. Some newer agents appear related to myositis or vasculitis. The origins of most of these syndromes remain obscure.
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Affiliation(s)
- Beth L Brogan
- Department of Medicine, Vanderbilt University, Nashville, Tennessee 37232-2681, USA
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Srivastava M, Rencic A, Diglio G, Santana H, Bonitz P, Watson R, Ha E, Anhalt GJ, Provost TT, Nousari CH. Drug-induced, Ro/SSA-positive cutaneous lupus erythematosus. ARCHIVES OF DERMATOLOGY 2003; 139:45-9. [PMID: 12533163 DOI: 10.1001/archderm.139.1.45] [Citation(s) in RCA: 112] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To study the clinical and immunopathologic findings of drug-induced, Ro/SSA-positive cutaneous lupus erythematosus (CLE). DESIGN Retrospective medical and laboratory record review. SETTING Immunodermatology Division of Johns Hopkins Hospital (Baltimore, Md). PATIENTS Of 120 patients found to have anti-Ro/SSA antibodies by hemagglutination and/or double immunodiffusion, 70 had clinical and immunopathologic confirmation of CLE. Fifteen of these 70 patients had a history of new drug exposure, defined as less than 6 months, associated with disease development. RESULTS The disease-associated drugs included hydrochlorothiazide (5 patients), angiotensin-converting enzyme inhibitors (3 patients), calcium channel blockers (3 patients), interferons (2 patients), and statins (2 patients). The most common presentations were photodistributed diffuse erythema and subacute CLE-type lesions without evidence of significant systemic disease. All specimens revealed interface dermatitis and fine granular IgG deposition along the basement membrane zone and throughout the epidermis. Most patients experienced improvement or resolution of clinical lesions within 8 weeks and decrease of Ro/SSA titers within 8 months after discontinuation of drug treatment. CONCLUSIONS Antihypertensive drugs are the most commonly associated with Ro-positive CLE. Clinical and immunopathologic features of this drug-induced variant do not seem to differ from the idiopathic disease. In most cases, the disease improves or resolves on discontinuation of the offending drug treatment. It is not known if these drugs precipitate disease in patients who have subclinical disease. Drug-induced Ro/SSA-positive CLE should be included on the differential diagnosis in patients presenting with photosensitive or subacute CLE-type eruptions.
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Affiliation(s)
- Monika Srivastava
- Department of Dermatology, Johns Hopkins Medical Institutions, Baltimore, MD, USA
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Affiliation(s)
- Nikolai Tsankov
- Department of Dermatology and Venereology, Sofia University of Medicine, Bulgaria.
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Callen JP. Drug-induced cutaneous lupus erythematosus, a distinct syndrome that is frequently unrecognized. J Am Acad Dermatol 2001; 45:315-6. [PMID: 11464200 DOI: 10.1067/mjd.2001.116583] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- J P Callen
- Division of Dermatology, University of Louisville School of Medicine, KY, USA
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Abstract
A 57-year-old woman was under treatment for epilepsy with lamotrigine 2 mg/kg/d since 1996. In April 1998 she was admitted to the Rheumatology Unit for arthralgias affecting the small joints of the hands, wrists and knees, erythematosus skin rash and myalgias. She referred a vascular abnormality at the hands exposed to cold, compatible with Raynaud's phenomenon. Serum antinuclear antibodies (ANA) were positive (1:320, speckled pattern); moreover, a positivity for anti-Ro/SSA was observed. Rheumatoid factor was negative, serum complement was normal. LAC and anticardiolipin antibodies were negative. Drug-related lupus diagnosis was made with resolution of symptoms and gradual normalisation of positivity of ANA and anti-Ro/SSA upon lamotrigine withdrawal. To our knowledge, this is the first case report of an association between lamotrigine and the onset of SLE (systemic lupus erythematosus).
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Affiliation(s)
- P Sarzi-Puttini
- Rheumatology Unit, Department of Internal Medicine, University Hospital L Sacco, Milan, Italy.
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Affiliation(s)
- S R Porter
- Department of Oral Medicine, Eastman Dental Institute for Oral Health Care Sciences, University College London, London, England, UK
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Braun-Falco O, Plewig G, Wolff HH, Burgdorf WHC. Reactions to Medications. Dermatology 2000. [DOI: 10.1007/978-3-642-97931-6_10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
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