Drug induced lupus Flashcards
When does drug induced lupus typically present in relation to initiation of drug?
> 1 year after drug initiation
How long after discontinuation of inciting drug does drug induced lupus resolve?
4-6 weeks
What are the two important antibodies for drug induced lupus?
+ anti histone
negative anti ds DNA
What are the common symptoms of drug induced lupus? What findings are typically absent?
-Arthritis/arthralgia (90%)
- myalgia (50%)
- serositis (pericarditis, pleurisy)
- fever and weight loss
renal, CNS and skin findings are typically absent
What are the high risk drugs a/w drug induced lupus?
- procainamide, hydralazine
What are the medium and low risk drugs a/w drug induced lupus?
- methyldopa
- quinidine
- isoniazid
D-penicillamine
- minocyline
- TNF-alpha inhibitors
Which drugs a/w drug induced lupus dont have the typical presentation of drug induced lupus?
- minocycline: often negative anti-histone and positive ANCA against elastase or MPO
- TNF-alpha inhibitors- anti ds-DNA frequently positive, which are usually negative (>anti-histone) and increased skin involvement (DILE usually lacks skin involvment)