Gold therapy in combination with Plaquenil ↑the risk of rash, and gold therapy should be given monthly. A number of sulfonylureas are also used as herbicides, because they can interfere with plant biosynthesis of certain amino acids. Wiznia LE, Subtil A, Choi JN. Parakeratosis, apoptosis, and basal vacuolization (×200, hematoxylin-eosin).
In 1 study, approximately 14% of rheumatoid arthritis patients treated with anti–TNF-α developed anti-DNA antibodies, whereas fewer than 1% developed lupuslike symptoms.Recognition of DILE in patients receiving anti–TNF-α agents can be difficult.A review by Ramos-Casals et al described 105 patients who developed DILE after starting anti–TNF-α therapy; in this group, lupuslike symptoms appeared at a mean time of 41 weeks after the initiation of anti–TNF-α therapy.As TNF-α–targeted therapies are being used for an expanding number of autoimmune diseases, the number of reports of their induction of lupuslike syndromes has been growing.
Diseases & Conditions
Most cases resolved within weeks of drug withdrawal.
Lowe G, Henderson CL, Grau RH, Hansen CB, Sontheimer RD. Pathak S, Cherry S, Samad S, Aftab A. Rare Occurrence of Drug Induced Subacute Cutaneous Lupus Erythematosus with Leflunomide Therapy. Bisphosphonates inhibit osteoclasts which are responsible for breaking down and reabsorbing minerals such as calcium from bone (the process is known as bone resorption). Burlingame RW. Susano R, Caminal L, Ramos D, Díaz B. Amiodarone induced lupus.
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. You've got the pronunciation of sulfonylurea right. Mendese G, Demierre MF. No significant differences in the clinical, histopathological, or immunopathological features between DISCLE and idiopathic SCLE were detected.Varying mechanisms leading to the formation of self-recognizing antibodies may explain the differential characteristics of drug effects in persons with DILE and those with SLE. Atenolol-induced lupus erythematosus. For example, whereas some drugs can cause DILE, others may cause a flare of preexisting SLE.Drugs such as procainamide, chlorpromazine, and quinidine cause the production of antinuclear antibodies against the histone dimer H2A-H2B.
The most common drugs that cause drug-induced SLE are hydralazine (rate roughly 20%), procainamide (rate roughly 20%, 5-8% if taken for 1 y), quinine, isoniazid, and minocycline.Drugs most commonly associated with drug-induced SCLE include calcium-channel blockers, angiotensin-converting enzyme inhibitors, thiazide diuretics TNF-alpha antagonists.Several broad drug categories have been linked to DILE, including those described below.Histamine H2 receptor antagonists include the following:A genetic predisposition may play a role. encoded search term (Drug-Induced Lupus Erythematosus) and Drug-Induced Lupus Erythematosus Physical Medicine and Rehabilitation for Systemic Lupus ErythematosusGlucocorticoid Use Linked to Increased Mortality Risk in Systemic Lupus ErythematosusRisks, Benefits of IV Belimumab in Children With SLE Consistent With AdultsDemand for Unproven COVID-19 Remedy Led to Shortages for SLE Patients Notable Knuckles, Part 2: Evaluating More Conditions of the HandResearch Examines Links Between 'Long COVID' and ME/CFSCough-Induced Rib Fractures in a Frequent Tea DrinkerSome Rheumatic Diseases Tied to Higher Risk of Severe COVID-19Glucocorticoid Use Linked to Increased Mortality Risk in Systemic Lupus ErythematosusRisks, Benefits of IV Belimumab in Children With SLE Consistent With AdultsShare cases and questions with Physicians on Medscape consult.
When one considers the large number of patients now treated with these biologic agents, the incidence of anti–TNF-α–induced DILE is relatively low.In a report of 33 cases of anti–TNF-α agents causing DILE, Costa et al found that 21 were due to infliximab, 10 to etanercept, and only 2 to adalimumab.Cutaneous findings in TNF-α–associated DILE commonly include photosensitivity and the classic cutaneous findings associated with Fever is found in similar incidence in both TNF-α inhibitor–induced DILE and DILE caused by other categories of medications. Widespread subacute cutaneous lupus erythematosus in a patient receiving checkpoint inhibitor immunotherapy with ipilimumab and nivolumab. Sign in to disable ALL ads. You can try again.Congrats, you have earned {{app.voicePoint}} pointsSince you have exceeded your time limit, your recording has been stopped.Unfortunately, this browser does not support voice recording.
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