Antinuclear antibodies as indicators for the procainamide-induced systemic lupus erythematosus-like syndrome and its clinical presentations.
Fifty patients on a regimen of procainamide were studied in regard to the association between antinuclear antibodies (ANA) and the development of drug-induced systemic lupus erythematosus (SLE)-like syndrome. Four groups were identified: Group 1 was ANA-positive, with clinical manifestations (serologic and clinical findings); Group 2 was ANA-positive, without clinical manifestations (serologic findings only); Group 3 was ANA negative (no patients with clinical manifestations); and Group 4 had SLE persisting after discontinuance of procainamide. The leukocyte-specific ANA (LSANA) patterns were predominant, with peripheral LSANA confined to Groups 1 and 4. Furthermore, the titer of the homogeneous LSANA, to which peripheral LSANA converts on dilution, was clinically significant. A homogeneous LSANA titer of 160 or greater was seen essentially only in patients with clinical manifestations of the SLE-like syndrome. Serial ANA determinations are therefore necessary to monitor patients receiving procainamide.
D000974:Antibodies, Antinuclear / Q000032:analysis*; D000918:Antibody Specificity; D000941:Antigens / Q000276:immunology; D034961:Antigens, Nuclear; D001145:Arrhythmias, Cardiac / Q000188:drug therapy; D004247:DNA / Q000276:immunology; D003852:Deoxyribonucleoproteins / Q000276:immunology; D005455:Fluorescent Antibody Technique; D006801:Humans; D007962:Leukocytes / Q000276:immunology; D008180:Lupus Erythematosus, Systemic / Q000139:chemically induced* / Q000175:diagnosis; D009698:Nucleoproteins / Q000276:immunology; D011342:Procainamide / Q000009:adverse effects* / Q000627:therapeutic use
D000974:Antibodies, Antinuclear; D000941:Antigens; D034961:Antigens, Nuclear; D003852:Deoxyribonucleoproteins; D009698:Nucleoproteins; D004247:DNA; D011342:Procainamide