Drug-induced lupus

In drug-induced lupus not all the typical features of systemic lupus erythematosus are seen, with renal and nervous system involvement being unusual. It usually resolves on stopping the drug.

Features

• arthralgia
• myalgia
• skin (e.g. malar rash) and pulmonary involvement (e.g. pleurisy) are common
• ANA positive in 100%, dsDNA negative
• anti-histone antibodies are found in 80-90%
• anti-Ro, anti-Smith positive in around 5%

Most common causes

• procainamide
• hydralazine

Less common causes

• isoniazid
• minocycline
• phenytoin