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

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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c) ANA disappears as soon as the offending drug is withdrawn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c)ANA disappears as soon as the offending drug is withdrawn: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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