Drug-induced lupus erythematosus is a type of lupus that occurs as a reaction to exposure to certain medications.
More than 40 drugs have been identified to cause drug-induced lupus, mainly those used to treat chronic conditions such as heart disease, thyroid disease, hypertension, neuropsychiatric disorders, inflammation, and epilepsy.
Medications that can cause drug-induced lupus
Drugs most often involved in drug-induced lupus include:
- Procainamide: Used to treat heart arrhythmia
- Hydralazine: Used to treat hypertension
- Quinidine: Used to treat heart arrhythmia
Classes of medications that have been connected to drug-induced lupus include:
- Antiarrhythmics (e.g., procainamide, quinidine)
- Antibiotics (e.g., minocycline)
- Anti-inflammatories (e.g., aspirin, naproxen)
- Antithyroid drugs
- Chemotherapy drugs
- Cholesterol drugs
- Hypertension drugs (e.g., hydralazine, diltiazem isoniazid)
- Proton pump inhibitors (e.g., omeprazole)
Most people who take these drugs will not develop the disease. Drug-induced lupus erythematosus is a rare adverse reaction. It is more commonly found in men because they are administered these medications more often.
What are symptoms of drug-induced lupus?
Symptoms of drug-induced lupus erythematosus often overlap with those of systemic lupus erythematosus (SLE). These include:
- Muscle aches and joint pain sometimes with swelling
- Flu-like symptoms such as fatigue and fever
- Serositis (inflammation around the heart or lungs that causes pain or discomfort)
- Skin rash on sun-exposed areas
Though the symptoms of drug-induced lupus and SLE are similar, rarely will any major organs be affected.
Who is at risk for developing drug-induced lupus?
Drug-induced lupus erythematosus mainly affects the following groups:
- Older people between ages 50-70
- Caucasians are more likely to get it than African Americans
Some predisposing genetic factors have been identified, including:
- Slow acetylator status (where the breakdown of medication by the liver is slower than usual)
- Certain tissue types, including HLA DR4, DR2, DR3, DR0301, DQB1, and B8
- Complement C4 null allele (an abnormality of a complement protein)
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Solhjoo M, Goyal A, Chauhan K. Drug-Induced Lupus Erythematosus. [Updated 2022 Apr 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441889/
Kauffman CL. Drug-Induced Lupus Erythematosus. https://emedicine.medscape.com/article/1065086-overview
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