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Drug Induced Lupus

Author: drashmiyadav, Posted on Friday, September 10 @ 23:26:44 IST by RxPG  

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Dermatology

    Q)The following is true about drug induced lupus:

    a) hypocomplementinemia present
    b) renal involvement occurs invariably
    c) ANA disappears as soon as the offending drug is withdrawn
    d) anti histone +ve



    Reference:Harrisons 15th ed pg 1926

    Quality:Thinker

    Discussion:

    Drug induced lupus is charcterised by:

  • Though the offending drug induces ANA in most (50-75%) cases,only 10-20% of ANA +ve individuals develop lupus-like syndrome.

  • Renal and CNS involvment is rare.

  • Antibodies to ds-DNA & hypocomplementinemia rare(distinguishing feature).

  • Anti histone is +ve.

  • Most patients improve in few weeks,on withdrawing the offending drug,but ANA may persist for years.


  • Explanation:

    a)hypocomplementinemia present:
    wrong option;hypocomplementinemia isn’t seen in drug induced lupus.

    b)renal involvement occurs invariably:
    renal and CNS involvment rare;wrong option

    c)ANA disappears as soon as the offending drug is withdrawn:
    ANA persists for years,even after withdrawing the offending drug.

    d)anti histone +ve: correct option.


    correct choice:(d) anti histone +ve

    know that:

    1)Most specific for SLE : a)Anti ds DNA
    b)Anti-sm

    2)Anti La(ss-B) : Sjogren’s syndrome(low risk of nephritis).

    3)Anti Ro : Neonatal lupus
    old age lupus
    ANA –ve lupus
    congenital heart block

    4)Most common offending drug in drug induced lupus is procainamide.


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