[Systemic lupus erythematosus induced by drugs].
The clinical and morphological characteristics of drug-induced lupus (DIL) are not unlike those of systemic lupus erythematosus (SLE). However, DIL is characterised by several distinct features: the two sexes are equally affected; onset occurs in advanced middle-age; the black population is seldom affected. Genetic predisposition seems to influence the onset of disease: subjects affected by DIL are prevalently HLA-DR4 haplotypes with a slow acetylator condition. Modifications in humoral immunity include the presence of anti-nuclear antibodies, denatured anti-DNA antibodies, and antihistone antibodies. Likewise, anti-lymphocytotoxic antibodies, increased ESR and hypocomplementemia are often observed. Little is known about alterations in cellular immunity but the dysregulation of lymphocyte T-helper and T-suppressor activity may be an important feature. Drugs most often leading to DIL include hydralazine, beta-blockers, procainamide and hydantoin. Current pathogenetic theories include a possible immune drug-DNA cross-reaction, the induction of new antigenic structures, an interaction between drugs and immunomodulating cells.
Parodi
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Istituto di Clinica Medica II, Università di Pavia.
D000889:Anti-Arrhythmia Agents / Q000009:adverse effects; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D000927:Anticonvulsants / Q000009:adverse effects; D000959:Antihypertensive Agents / Q000009:adverse effects; D014150:Antipsychotic Agents / Q000009:adverse effects; D000995:Antitubercular Agents / Q000009:adverse effects; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000139:chemically induced*
D000889:Anti-Arrhythmia Agents; D000900:Anti-Bacterial Agents; D000927:Anticonvulsants; D000959:Antihypertensive Agents; D014150:Antipsychotic Agents; D000995:Antitubercular Agents