Hydralazine-induced systemic lupus erythematosus presenting as pyoderma gangrenosum-like ulcers.
A 48-year-old white woman who for 3 years had been taking hydralazine, 100 mg three times a day, propranolol, 160 mg twice a day, and chlorothiazide, 500 mg/day, for hypertension suddenly developed rapidly expanding ulcers that looked like pyoderma gangrenosum. Arthralgias, fevers, and occasional shortness of breath were also noted. A pericardial effusion was diagnosed by echocardiography. The antinuclear antibody (ANA) titer on routine mouse liver substrate was initially negative, but the ANA titer was positive (1:1,920) on human epithelioid cell substrate. Antibodies to histones and single-stranded DNA were also elevated. After discontinuing hydralazine, all signs and symptoms cleared over a 4-week period. At the time of discharge the ANA titer had decreased to 1:480.
D000974:Antibodies, Antinuclear / Q000032:analysis; D001323:Autoantibodies / Q000032:analysis; D003875:Drug Eruptions / Q000209:etiology; D005260:Female; D006801:Humans; D006830:Hydralazine / Q000009:adverse effects*; D008180:Lupus Erythematosus, Systemic / Q000139:chemically induced* / Q000150:complications / Q000276:immunology; D008875:Middle Aged; D011711:Pyoderma / Q000209:etiology*
D000974:Antibodies, Antinuclear; D001323:Autoantibodies; D006830:Hydralazine