Methyldopa-induced systemic lupus erythematosus.
Thirteen months after starting methyldopa therapy, a 55-year-old white male patient presented with a syndrome of hemolytic anemia, arthritis, photosensitivity, and a positive antinuclear antibody test result. Methyldopa-induced antinuclear antibodies were mainly IgG, directed against class H1 histones. Antibodies to native DNA and nonhistone proteins were not detected. Upon withdrawal of methyldopa therapy, and with a short course of prednisone and danazol therapy, the patient's symptoms and hemolytic anemia resolved. His clinical symptoms and serologic abnormalities returned to normal and remained negative after 2 years of followup.
Nordstrom
D M
DM
Department of Medicine, Fitzsimons Army Medical Center, Aurora, CO 80045.
West
S G
SG
Rubin
R L
RL
D000974:Antibodies, Antinuclear / Q000032:analysis; D004797:Enzyme-Linked Immunosorbent Assay; D005455:Fluorescent Antibody Technique; D005500:Follow-Up Studies; D006657:Histones / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D007075:Immunoglobulin M / Q000032:analysis; D008180:Lupus Erythematosus, Systemic / Q000139:chemically induced* / Q000175:diagnosis / Q000276:immunology; D008297:Male; D008750:Methyldopa / Q000009:adverse effects*; D008875:Middle Aged; D013997:Time Factors
D000974:Antibodies, Antinuclear; D006657:Histones; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D008750:Methyldopa