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drug-induced lupus erythematosus

Alternative Names
drug-induced lupus, medication-induced lupus

Definition
Systemic lupus erythematosus, called SLE or lupus, is a poorly understood autoimmune disorder. A lupus-like syndrome can sometimes be caused by medications.

What is going on in the body?
Lupus is an autoimmune disorder. This means that a person's immune system attacks his or her own body for unknown reasons. Occasionally, medications given for other health problems can cause a condition similar to lupus to develop.

What are the signs and symptoms of the condition?
Drug-induced lupus causes many of the same symptoms as regular lupus. These may include: What are the causes and risks of the condition?
The medications hydralazine and procainamide are thought to definitely cause a lupus-like syndrome. Hydralazine is usually used to treat high blood pressure. Procainamide is often used to treat irregular heartbeats, or arrhythmias. The symptoms of lupus may not appear at low doses of these medications. However as the dose increases, the lupus-like syndrome may appear.

Many other medications are suspected to cause lupus in some cases. However, the evidence is not as clear-cut as it is with these two medications.

What can be done to prevent the condition?
Many times, the medications thought to cause lupus are required to treat other disorders. This means that the condition often cannot be prevented. Lupus-like syndrome is an unforeseeable side effect of these commonly used medications. While the condition can not be prevented, withdrawal of the medication does solve the problem. Most people who take hydralazine and procainamide do not develop the lupus-like syndrome.

How is the condition diagnosed?
A doctor may suspect drug-induced lupus based upon:
  • the history of medications taken
  • a person's symptoms
  • findings of the physical exam
Blood tests can confirm the diagnosis in most cases.

What are the long-term effects of the condition?
Usually, there are no long-term effects. Withdrawal of the medication generally reverses the symptoms of drug-induced lupus.

What are the risks to others?
Drug-induced lupus is not a contagious disease.

What are the treatments for the condition?
Stopping the medication causes the lupus to go away in almost all cases. Other medications, such as analgesics, may be given while waiting for symptoms to stop.

What are the side effects of the treatments?
Stopping a medication may cause the problem it was prescribed for to come back. Analgesia, such as aspirin, may cause allergic reactions or stomach upset. Other side effects vary depending on the medication used.

What happens after treatment for the condition?
The person can generally go back to normal activities after treatment.

How is the condition monitored?
Once the medication is stopped and symptoms go away, no further monitoring for the lupus is generally needed. The medication that caused the problem should not be used again.

Author:
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request


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