How is drug-induced lupus erythematosus differentiated from systemic lupus erythematosus (SLE)?

Updated: Aug 04, 2021
  • Author: Christie M Bartels, MD, MS; Chief Editor: Herbert S Diamond, MD  more...
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Answer

Before making a diagnosis of systemic lupus erythematosus (SLE), ruling out drugs as the cause of the condition is important. Many pharmacologic agents have been associated with a lupuslike syndrome (see see Drug-Induced Lupus Erythematosus), but procainamide, hydralazine, and isoniazid have been studied the most extensively. Many patients who take these medications have positive antinuclear antibody test results and other serologic findings. Only a few have the clinical manifestations. Drug-induced lupus differs from SLE by the following features:

  • Sex ratios are nearly equal

  • Antibodies to histones are usually found in 80-90%

  • Nephritis and central nervous system features are not commonly present

  • There are no antibodies to native DNA or hypocomplementemia

  • Discontinuation of the drug leads to resolution of clinical manifestations and reversion of abnormal laboratory values to normal


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