There are contrasts in the presentation of the clinical signs and symptoms of DIL due to minocycline. There is a higher female to male ratio Newer Agents: Anti-TNF-alpha agents are used in the treatment of diseases such as rheumatoid arthritis and psoriasis.
Case reports for DIL have been reported with etanercept and infliximab. Fever, malaise, arthritis, and rash were reported. Renal and neurologic involvement was rarely reported. The mainstay of treatment for DIL is to withdraw the offending agent; symptom improvement can be seen within days to weeks after discontinuation of the drug.
In drug-induced CCLE, topical corticosteroids in combination with hydroxychloroquine have been used. The possible side effects that can occur include but are not limited to dizziness, drowsiness, headache, pruritus, edema, and fluid retention.
Topical Corticosteroids: Hydrocortisone, betamethasone, and fluticasone are some examples of topical corticosteroids that may be used for skin rash or skin lesions. A thin layer of the substance should be applied to the affected area two to three times daily.
Common side effects are dryness, itching, skin atrophy, and erythema. Systemic Corticosteroids : Prednisone and methylprednisolone are often used to treat symptoms of DIL. The side effects commonly seen are headache, mood swings, fluid and electrolyte imbalance, insomnia, peptic ulcers, and urticaria.
Hydroxychloroquine: The dose commonly used is mg once or twice daily. Side effects typically seen are nausea, vomiting, diarrhea, alopecia, corneal changes and deposits, and pigmentation changes. Many drugs currently available are capable of inducing autoantibodies, which can lead to a drug-induced disease such as DIL.
Thus far, at least 80 medications have been identified that can cause DIL. Specific criteria for the diagnosis of DIL have not been defined, but recommendations have been made to aid in its diagnosis. New drugs are increasingly entering the market with a mechanism of action that modifies the immunologic response in the patient. For pharmacists, an awareness of the potential adverse effects of these medications can help with the identification of this drug-induced syndrome in patients.
Patients should also be counseled to be aware of the signs and symptoms of DIL and encouraged to report any concerns to their physician. Drug-induced lupus erythematosus. Clin Dermatol. Drug-induced rheumatic syndromes. Curr Opin Rheumatol. Hess E. Drug-related lupus. Rubin RL. Expert Opin Drug Saf. In: Tsokos GC, ed. Systemic Lupus Erythematosus. Drug-induced lupus: traditional and new concepts. Autoimmun Rev. Updated by: Diane M.
Review provided by VeriMed Healthcare Network. Editorial team. Drug-induced lupus erythematosus. The most common medicines known to cause drug-induced lupus erythematosus are: Isoniazid Hydralazine Procainamide Tumor-necrosis factor TNF alpha inhibitors such as etanercept, infliximab and adalimumab Minocycline Quinidine Other less common drugs may also cause the condition.
These may include: Anti-seizure medicines Capoten Chlorpromazine Methyldopa Sulfasalazine Levamisole, typically as a contaminant of cocaine Cancer immunotherapy drugs such as pembrolizumab can also cause a variety of autoimmune reactions including drug-induced lupus. Symptoms of drug-induced lupus tend to occur after taking the drug for at least 3 to 6 months. Symptoms may include: Fever General ill feeling malaise Joint pain Joint swelling Loss of appetite Pleuritic chest pain Skin rash on areas exposed to sunlight.
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Shareable Toolkit. Sign Up for Emails. Tell Your Story. Media Relations. Contact Us. Annual Report. National Lupus Partners Network. What is drug-induced lupus? Drug-induced lupus is a lupus-like disease caused by certain prescription drugs.
The drugs most commonly connected with drug-induced lupus are: hydralazine used to treat high blood pressure or hypertension procainamide used to treat irregular heart rhythms isoniazid used to treat tuberculosis Drug-induced lupus is more common in men because they are given these drugs more often; however, not everyone who takes these drugs will develop the disease.
The symptoms of drug-induced lupus Specific criteria for diagnosing drug-induced lupus have not been formally established. Depending on your symptoms, you may also have:. A laboratory test called the antinuclear antibody panel ANA is used to check your blood for histone-DNA complex antibodies. The presence of these antibodies suggests a diagnosis of drug-induced lupus.
Some people who have lupus due to quinidine or hydralazine may test ANA-negative. If you have a skin rash, your doctor can take a tissue sample. When lupus is due to a drug, symptoms should begin to clear up when you stop taking it.
You should begin to improve within a few weeks, though it can take longer for symptoms to go away completely. Generally, no other treatment is needed. If you were to start taking that drug again, your symptoms would return. Your doctor will work with you to find a substitute for the medication that caused the problem.
If symptoms are severe, your doctor may consider prescribing corticosteroids or NSAIDs to help control inflammation. Topical corticosteroids can be used on the skin rash, if needed. In addition to your primary care doctor, you may need to see a specialist to confirm the diagnosis. Depending on your symptoms, these can include:. Since drug-induced lupus is likely to improve once you stop taking the drug, long-term treatment is usually not necessary.
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