The possibility that drug induced lupus erythematosus dile can be induced by donepezil is presented in this clinical case. Drug induced lupus erythematosus dile is a syndrome that is formed by lupus like symptoms and laboratory characteristics. Acute interstitial nephritis and druginduced systemic lupus. Pediatric systemic lupus erythematosus american academy of. Druginduced lupus erythematosus is an uncommon, mild to moderately severe, a lupus like syndrome related in time to continuous exposure to a specific medication and which resolves after the trigger drug is ceased. Donepezil is an inhibitor of acetylcholinesterase used for the treatment of alzheimers disease. Drug induced lupus erythematosus dile is a syndrome that is formed by lupuslike symptoms and laboratory characteristics. Lupus erythematosus is an autoimmune disease of the connective tissue, whose specific causes are still unknown. Druginduced lupus erythematosus following immunotherapy. Drug induced lupus erythematosus is an autoimmune disorder that is triggered by a reaction to a medicine. Hydralazineinduced isolated lupus nephritis ochsner journal. Although the pathogenesis of dil is not well understood, a genetic predisposition may play a role in the case of certain drugs, particularly those agents that are metabolised by acetylation such as procainamide and hydralazine, with disease more likely to. Druginduced lupus erythematosus is a lupuslike syndrome induced by an offending agent or drug.
In the last 40 years many drugs and other chemical agents have been reported to cause a syndrome similar to systemic lupus erythematosus sle. Druginduced lupus erythematosus by amiodarone rheumatology. Here, we report the case of a 39yearold man with onset of cutaneous discoid lupus erythematosus during subcutaneous administration of the il17a. Druginduced lupus dil is a disorder with clinical, histological, and immunological features similar to idiopathic systemic lupus erythematosus, but that occurs when certain drugs are taken. Many drugs can trigger a lupuslike illness associated with autoantibodies, but typically with fewer disease manifestations and temporal association with the offending agent. Capecitabine is an orally administered tumorselective fluoropyrimidine that acts as a prodrug of 5fluorouracil and bevacizumab is an antivascular endothelial growth factor antivegf antibody, both are used for the treatment of patients with colorectal cancer. One patient with druginduced lupus had been taking 200 mg of hydralazine daily for two years and had the findings of polyarthritis, positive lupus erythematosus le cells in the peripheral. Drug induced lupus dil is a disorder with clinical, histological, and immunological features similar to idiopathic systemic lupus erythematosus, but that occurs when certain drugs are taken and resolves after discontinuation of the offending agent.
A suspected case of isoniazid induced systemic lupus erythematosus was confirmed by the presence of serum antinuclear antibodies. This phenomenon was first described in 1945 in association with sulfadiazine. First, by contrast with idiopathic sle, formal diagnostic. Systemic lupus erythematosus sle is a chronic, multisystem, autoimmune disease characterized by periods of increased disease activity caused by inflammation of blood vessels and connective tissue. First, by contrast with idiopathic sle, formal diagnostic criteria for druginduced sle have not been established. Dil and druginduced lupus erythematosus dile are preferred, but other ones are also useddrugrelated lupus, lupuslike syndrome, and lupus erythematosus. A recent similar case report of pembrolizumabrelated subacute cutaneous lupus erythematosus was provided.
Both the idiopathic and druginduced forms of scle are analogous in their clinical, serological and. Drug induced lupus erythematosus dile is a lupus like illness that has been recognized as an entity under environmentally induced lupus erythematosus, where other agents such as physical ultraviolet irradiation, chemical heavy metals, aromatic amines and food products alfalfa sprouts have been implicated. Druginduced lupus erythematosus dil or dile is an autoimmune disorder similar to systemic lupus erythematosus sle caused by chronic use of certain drugs. Druginduced lupus erythematosus dile is a disorder that exhibits symptoms similar to that of lupus. Druginduced lupus erythematosus thearchangelmichaels blog.
Subacute cutaneous lupus erythematosus scle is a welldefined subtype of lupus erythematosus, characterised by photosensitivity, annular andor psoriasiform lesions, variable systemic involvement and presence of circulating ssaantiro antibodies. Druginduced lupus is when its caused by taking certain prescription medicines for. Drug induced autoimmune syndromes have been recognized for some time. Druginduced lupus erythematosus uf health, university. Over 90 drugs have been linked to dile to date and the list is growing. A suspected case of isoniazidinduced systemic lupus erythematosus was confirmed by the presence of serum antinuclear antibodies. The drugs most commonly implicated are hydralazine, procainamide, quinidine, isoniazid, diltiazem. Lupus is a condition that can happen when your bodys immune system attacks your healthy tissues and organs. Rheumatologic symptoms including fever, malaise, weight loss, pol. There are an estimated 15,000 to 30,000 cases of druginduced lupus per year in the united states. The symptoms of druginduced lupus are similar to those of systemic lupus, but only rarely will any major organs be affected. The most common individual agents are procainamide and hydralazine.
The demographic characteristics of druginduced lupus largely depend upon the populations most likely to receive the relevant drugs. Pediatric systemic lupus erythematosus american academy. Typical features include rash, myalgia, and arthritis. The terms used for this condition are lupus like syndrome, drug induced lupus erythematosus, drug related lupus, and lupus erythematosus. Related conditions are druginduced cutaneous lupus and. Jul 10, 2018 drug induced lupus erythematosus dile is a variant of lupus erythematosus that resolves within days to months after withdrawal of the culprit drug in a patient with no underlying immune system dysfunction. Druginduced lupus erythematosus associated with donepezil. Aug 24, 2002 next article druginduced systemic lupus erythematosus and tnf. Drug induced lupus erythematosus is similar but not identical to systemic lupus erythematosus sle. Dile can arise months to years after exposure to drugs prescribed to treat various medical conditions eg, antihypertensives, antibiotic. Intravenous immunoglobulin g use in patients with chronic. The demographic characteristics of drug induced lupus largely depend upon the populations most likely to receive the relevant drugs. Both the idiopathic and drug induced forms of scle are analogous in their clinical, serological and.
Related conditions are drug induced cutaneous lupus and drug induced anca vasculitis. It is generally equally common in males and females, and more common in older people and white populations. Pdf druginduced lupus erythematosus donatella schena. Druginduced lupus erythematosus clinical presentation. Druginduced lupus erythematosus following immunotherapy with. Drug induced lupus erythematosus is an autoimmune disorder similar to systemic lupus erythematosus sle caused by chronic use of certain drugs. Sep 20, 2019 isoniazid, an antituberculosis drug, can cause systemic lupus erythematosus sle. Jul 10, 2018 most patients with drug induced lupus erythematosus dile have 1 or more clinical symptoms of systemic lupus erythematous sle, such as arthralgias, lymphadenopathy, rash, and fever, and have no prior history of autoimmune disease. Acute interstitial nephritis and druginduced systemic. Druginduced lupus is a syndrome which share symptoms and laboratory characteristics with idiopathic systemic lupus erythematosus sle. Aug 16, 2018 drug induced lupus erythematosus dile is a disorder that exhibits symptoms similar to that of lupus.
Although the pathogenesis of dil is not well understood, a genetic predisposition may play a role in the case of certain drugs, particularly those. Recently, it was also described with interleukin il 17 inhibition. Druginduced, rossapositive cutaneous lupus erythematosus. Most cases of scle are idiopathic, but occasional cases may be drug. Druginduced lupus erythematosus with emphasis on skin. Compare risks and benefits of common medications used for lupus erythematosus. Aug 24, 2002 in their report of systemic lupus erythematosus sle associated with etanercept, najia shakoor and colleagues feb 16, p 5791 discuss four patients who developed antinuclear antibodies, or antibodies to doublestranded dna dsdna or histones. It usually develops only after months and, quite commonly, years of treatment with the offending agent, although latencies of days or weeks have been described in some instances. Druginduced lupus erythematosus is an uncommon, mild to moderately severe, a lupuslike syndrome related in time to continuous exposure to a specific medication and which resolves after the trigger drug is ceased. Druginduced lupus erythematosus clinics in dermatology. Clinical features of patients with drug induced, rossapositive cutaneous lupus erythematosus cle. The terms used for this condition are lupuslike syndrome, druginduced lupus erythematosus, drugrelated lupus, and lupus erythematosus.
Drugs less frequently associated with the disease are chlorpromazine, isoniazid, methyldopa, penicillamine, quinidine and sulfasalazine. Various medications have been associated with drug. Objective to study the clinical and immunopathologic findings of drug induced, rossapositive cutaneous lupus erythematosus cle. Druginduced lupus erythematosus uf health, university of. Dil and druginduced lupus erythematosus dile are preferred, but other ones are also used drug related lupus, lupus like syndrome, and lupus erythematosus. We believe the title of the report and the clinical laboratory features may be misleading. Mary anne dooley, in systemic lupus erythematosus, 2016. Drug induced lupus erythematosus dile is a lupus like syndrome temporally related to continuous drug exposure from one month to as long as over a decade which resolves after discontinuation of the drug. After cessation of amiodarone treatment, the patient recovered completely. It is an autoimmune phenomenon that has been accepted as a side effect of therapy with dozens of drugs since its first description in association with sulfadiazine in 1945. Next article druginduced systemic lupus erythematosus and tnf.
Systemic lupus erythematosus sle is an autoimmune disease of unknown origin, but many drugs have been seen to induce lupus like signs and symptoms. The terms drug induced lupus dil and drug induced lupus erythematosus dile are preferred, but other ones are also used drug related lupus, lupus like syndrome and lupus erythematosus medicamentosus. The generation of autoantibodies and autoimmune diseases such as systemic lupus erythematosus has been associated with the use of certain drugs in humans. Druginduced lupus erythematosus is a result of sideeffects, which occur due to prolonged usage of certain medications. Druginduced lupus dil is a side effect of longterm use of up to 100 medications. Oct 26, 2012 drug induced lupus is a syndrome resembling mild systemic lupus erythematosus which can complicate treatment with certain apparently unrelated therapies. Drug induced lupus erythematosus dile refers to a condition whose clinical, histological, and immunological features are similar to those seen in idiopathic lupus erythematosus but that occurs.
Druginduced lupus erythematosus dile is a lupuslike illness that has been recognized as an entity under environmentallyinduced lupus erythematosus, where other agents such as physical ultraviolet irradiation, chemical heavy metals, aromatic amines and food products alfalfa sprouts have been implicated. No specific criteria have been established yet to arrive at a diagnosis of druginduced lupus. The terms druginduced lupus dil and druginduced lupus erythematosus dile are preferred, but other ones are also useddrugrelated lupus, lupuslike syndrome, and lupus erythematosus medicamentosus. Drug induced lupus erythematosus is an uncommon, mild to moderately severe, a lupus like syndrome related in time to continuous exposure to a specific medication and which resolves after the trigger drug is ceased. The terms druginduced lupus dil and druginduced lupus erythematosus dile are preferred, but other ones are also useddrugrelated lupus, lupuslike syndrome and lupus erythematosus medicamentosus. While there are currently no definitive diagnostic criteria for dile, the clinical syndrome encompasses features similar to systemic lupus erythematosus sle, subacute cutaneous lupus erythematosus scle, or discoid lupus erythematosus dle. Druginduced lupus erythematosus dile is an idiosyncratic reaction where a drug exposure leads to the development of systemic lupus erythematosus sle like clinical features, without preexisting lupus. Druginduced lupus erythematosus dile refers to a condition whose clinical, histological, and immunological features are similar to those seen in idiopathic lupus erythematosus but that occurs when certain drugs are taken and resolves after their withdrawal. The drugs most commonly connected with drug induced lupus are hydralazine used. There are an estimated 15,000 to 30,000 cases of drug induced lupus per year in the united states. Druginduced lupus erythematosus dile is defined as a lupus like syndrome temporally related to continuous drug exposure which resolves after discontinuation of the offending drug.
Druginduced lupus erythematosus dile refers to a condition whose clinical, histological, and immunological features are similar to those seen in idiopathic lupus erythematosus but that occurs. Topical druginduced subacute cutaneous lupus erythematosus. Druginduced lupus erythematosus information mount sinai. Summary subacute cutaneous lupus erythematosus scle. Druginduced lupus erythematosus dile is a variant of lupus erythematosus that resolves within days to months after withdrawal of the culprit drug in a patient with no underlying immune system dysfunction. Druginduced lupus erythematosus is an autoimmune disorder that is triggered by a reaction to a medicine.
Druginduced lupus erythematosus is a rare adverse event of biological treatment, mainly observed with tumor necrosis factor. Drug induced lupus erythematosus dile is an uncommon autoimmune disorder caused by certain drugs, most commonly hydralazine and procainamide. In their report of systemic lupus erythematosus sle associated with etanercept, najia shakoor and colleagues feb 16, p 5791 discuss four patients who developed antinuclear antibodies, or antibodies to doublestranded dna dsdna or histones. Drug induced lupus is a lupus like disease caused by certain prescription drugs. We report a case with typical clinical features of drug induced lupus erythematosus, together with verrucous endocarditis and pleuropericardial effusion, due to amiodarone treatment. Drug induced lupus is a syndrome which share symptoms and laboratory characteristics with idiopathic systemic lupus erythematosus sle.
Druginduced lupus erythematosus is an autoimmune disorder similar to systemic lupus erythematosus sle caused by chronic use of certain drugs. Drug induced lupus erythematosus is a lupus like syndrome induced by an offending agent or drug. No specific criteria have been established yet to arrive at a diagnosis of drug induced lupus. This means your body attacks healthy tissue by mistake. Druginduced lupus is a lupuslike disease caused by certain prescription drugs.
Dile shows less predilections for women and africans, and generally affects older patients than idiopathic sle. We report a case with typical clinical features of druginduced lupus erythematosus, together with verrucous endocarditis and pleuropericardial effusion, due to amiodarone treatment. The classic example is drug induced lupus erythematosus dile. Druginduced lupus is a syndrome resembling mild systemic lupus erythematosus which can complicate treatment with certain apparently unrelated therapies. These drugs cause an autoimmune response the body attacks its own cells producing symptoms similar to those of sle. Drug induced lupus erythematosus due to capecitabine and. As in idiopathic or usualtype lupus erythematosus le, there are three categories recognised. A, the index patient shows scaly, annular, subacute cletype lesions on the lateral aspect of the right arm. Dile shows less predilections for women and africans. The other four patients had pleurisy as one of the initial manifestations of lupus, two had druginduced disease, and two had systemic lupus erythematosus. Druginduced lupus erythematosus dilesymptomstreatment. The drugs most commonly connected with druginduced lupus are hydralazine used. Druginduced lupus erythematosus dile is marked by the development of immunological and dermatological manifestations after the initiation of one or more medications while hydralazine and antihistone antibodies are the bestknown examples, other drugs have been known to cause a lupuslike reaction. This report is the first series of cases of lupus erythematosus induced by antipdl1 immunotherapy.
Secukinumabinduced chronic discoid lupus erythematosus. The possibility that druginduced lupus erythematosus dile can be induced by donepezil is presented in this clinical case. The symptoms of drug induced lupus are similar to those of systemic lupus, but only rarely will any major organs be affected. Medications such as hydralazine, procainamide, methyldopa, chlorpromazine, quinidine, and minocycline are known to cause sle. Druginduced lupus erythematosus dile is a lupuslike syndrome temporally related to continuous drug exposure from one month to as long as over a decade which resolves after discontinuation of the drug. Setting immunodermatology division of johns hopkins hospital baltimore, md.
37 776 829 1614 1124 286 671 339 1316 1174 1160 359 5 791 1244 669 945 490 392 984 729 1124 1564 736 738 1186 727 584 949 539 1066 367 340 1095 1415 456 166 649