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Drug-Induced Lupus — SCE Rheumatology MCQ

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EasySLE & Antiphospholipid SyndromeDrug-Induced LupusSCE Rheumatology

A 25-year-old woman develops photosensitive rash joint pain and positive ANA after starting Hydralazine for hypertension in pregnancy. Anti-histone antibodies are positive while anti-dsDNA is negative. Which drugs are most commonly associated with drug-induced lupus?

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Correct answer: A — Hydralazine Procainamide Isoniazid and Minocycline

The most commonly implicated drugs in drug-induced lupus are Hydralazine Procainamide Isoniazid Minocycline and Quinidine. TNF inhibitors can also cause drug-induced lupus. Characteristically anti-histone antibodies are positive (>95%) while anti-dsDNA is typically negative (except in TNF inhibitor-induced lupus where anti-dsDNA can be positive). Complement levels are usually normal. Symptoms typically resolve within weeks to months of stopping the causative drug. Severe organ involvement (renal CNS) is rare distinguishing it from idiopathic SLE.

Reference: Rubin RL 2015 drug-induced lupus