Serologic changes during induction of lupus-like disease by procainamide.
Procainamide-induced lupus is a well-recognized syndrome, but the events leading up to clinical symptoms are obscure. In the present study, serologic changes in a 69-year-old man were monitored during his treatment with procainamide and after discontinuation of procainamide because of symptoms of drug-induced lupus. Antihistone antibodies of unique specificity and in vivo complement activation were detected after one year of procainamide therapy during a period prior to development of significant clinical symptoms. Antihistone antibodies and complement activation substantially increased during a full-blown episode of lupus-like symptoms. Progressive return to normal laboratory findings occurred after procainamide was discontinued. The antihistone/complement profile may be useful in the diagnosis of drug-induced lupus and warn of impending clinical deterioration in patients with minimal symptoms.
Rubin
R L
RL
Nusinow
S R
SR
Johnson
A D
AD
Rubenson
D S
DS
Curd
J G
JG
Tan
E M
EM
D000368:Aged; D000906:Antibodies / Q000032:analysis; D003167:Complement Activation / Q000187:drug effects; D006657:Histones / Q000276:immunology; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000139:chemically induced* / Q000175:diagnosis; D008297:Male; D010198:Pancytopenia / Q000139:chemically induced / Q000175:diagnosis; D011342:Procainamide / Q000009:adverse effects*; D011379:Prognosis; D011446:Prospective Studies; D013997:Time Factors
D000906:Antibodies; D006657:Histones; D011342:Procainamide