Hydralazine-induced autoimmune disease: comparison to idiopathic lupus and ANCA-positive vasculitis.
We report two cases of hydralazine-induced vasculitis with rare complications: pulmonary renal syndrome and digital gangrene. We also review 68 published cases of hydralazine-induced vasculitis. Hydralazine-induced vasculitis mimics idiopathic antineutrophil cytoplasmic antibody (ANCA)-positive vasculitis. However, it also produces other autoantibodies, such as antinuclear antibodies, antihistone antibodies, anti-dsDNA antibodies, and antiphospholipid antibodies. Patients with hydralazine-induced vasculitis typically have a more severe course than those with hydralazine-induced lupus, predominantly due to renal vasculitis, and require a more aggressive treatment.
Yokogawa
Naoto
N
Division of Rheumatology, University of Pennsylvania, Philadelphia, PA, USA. yokogawan@aol.com
Vivino
Frederick B
FB
D000368:Aged; D000369:Aged, 80 and over; D019268:Antibodies, Antineutrophil Cytoplasmic; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006830:Hydralazine / Q000009:adverse effects*; D008181:Lupus Nephritis / Q000139:chemically induced* / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D018366:Vasculitis, Leukocytoclastic, Cutaneous / Q000139:chemically induced* / Q000175:diagnosis* / Q000503:physiopathology; D014665:Vasodilator Agents / Q000009:adverse effects*
D019268:Antibodies, Antineutrophil Cytoplasmic; D014665:Vasodilator Agents; D006830:Hydralazine