Drug induced lupus (DIL) is a side effect of long term use of certain medications. These drugs cause an autoimmune response (the body attacks its own cells) producing symptoms similar to those of SLE, but it is not generally as severe as SLE.
Symptoms that occur in both disorders include: muscle and joint pain and swelling, flu-like symptoms such as fatigue and fever, serositis (inflammation around the lungs or heart that causes pain or discomfort), skin rash, Raynaud's phenomenon and positive ANA test results.
Once the suspected medication is stopped, symptoms should decline within days. Usually symptoms disappear within one or two weeks, although there are reported cases of DIL that do not go away completely after the offending drug is removed.
Drug-induced lupus can be diagnosed with certainty only by resolution of symptoms and their failure to recur after stopping the medication.
Besides stopping the offending drug, short term use of non-steroidal anti-inflammatory drugs (NSAIDs) may be used to help symptoms resolve faster. In patients with severe symptoms of DIL, corticosteroids may be used to help reduce inflammation.
There is a list of over 100 drugs that can cause lupus, the symptoms will often appear after a person has been on high doses of the medication over a number of years.
As DIL is potentially a "curable" cause of lupus, it is important to consider that medication may trigger lupus.
Below are just some of the drugs and chemicals:
Proven Association:
Chlorpromazine, Hydralazine (used to treat high blood pressure), Penicillamine, Isoniazid, a-Methyldopa, Procainamide (used to treat tachyycardia), Sulphasalazine (used in colitis, crohn's disease and rheumatoid arthritis).
Tentative Association:
Acebutol, Atenolol, Captopril, Carbamezapine, Cimetidine, Dapsone, Ethosuximide, Hydrazine, Oxyprenolol, Phenezine, Phenytoin, Pindolol, Practolol, Propranolol, Propylthiouracil, Quinidine
Case Reports:
Allopurinol, Chloprothixene, Chlorthalidone, Debrisoquine, Ethylphenacimide, Gold Salts, Grisofulvin, L-Canavarine, Methysegide, Oral Contraceptives, Penicillin, Phenybuzatone, Reserpine, Streptomycin, Tetracycline (in particular Minocycline, used for acne), Proton pump inhibitors such as omeprazole.
However, some drugs such as methyldopa can be used for short periods in patients with lupus, including in pregnancy.
