Drug-induced Lupus Erythematosus: When to Suspect and How to Diagnose
Résumé
Key Takeaways
1. Drug-induced lupus is rare but can occur after prolonged exposure to medications commonly used in gastroenterology, namely proton pump inhibitors and anti-TNF alpha biologic agents.
2. Autoantibodies (ANA and dsDNA) are commonly observed with the use of anti-TNF alpha biologic agents. However, drug-induced lupus should be suspected in the presence of symptoms, primarily rash or arthritis.
3. Clinical manifestations of drug-induced lupus are milder than those of systemic lupus erythematosus and should resolve with cessation of the offending medication.
Références
Rubin RL. Drug-induced lupus. Toxicology. 2005;209(2):135–147. doi:10.1016/j.tox.2004.12.025
Hess E. Drug-related lupus. N Engl J Med. 1988;318(22):1460–1462. doi:10.1056/nejm198806023182209
Hoffman BJ. Sensitivity to sulfadiazine resembling acute disseminated lupus erythematosus. Arch Dermatol Syphilol. 1945;51(3):190–192. doi:10.1001/archderm.1945.01510210032007
Antonov D, Kazandjieva J, Etugov D, Gospodinov D, Tsankov N. Drug-induced lupus erythematosus. Clin Dermatol. 2004;22(2):157–166. doi:10.1016/j.clindermatol.2003.12.023
Xiao X, Chang C. Diagnosis and classification of drug-induced autoimmunity (DIA). J Autoimmun. 2014;48-49:66–72. doi:10.1016/j.jaut.2014.01.005
Crowson AN, Magro CM. Cutaneous histopathology of lupus erythematosus. Diagnostic Histopathology. 2009;15(4):157–185. doi:https://doi.org/10.1016/j.mpdhp.2009.02.006
De Bandt M, Sibilia J, Le Loët X, Prouzeau S, Fautrel B, Marcelli C, et al. Systemic lupus erythematosus induced by anti-tumour necrosis factor alpha therapy: a French national survey. Arthritis Res Ther. 2005;7(3):R545–R551. doi:10.1186/ar1715
Costa MF, Said NR, Zimmermann B. Drug-induced lupus due to anti-tumor necrosis factor alpha agents. Semin Arthritis Rheum. 2008;37(6):381–387. doi:10.1016/j.semarthrit.2007.08.003
Petty AJ, Cardones AR, Marano AL. Analysis of clinical characteristics of drug-induced cutaneous lupus erythematosus in men. J Am Acad Dermatol. 2020;83(5):1455–1457. doi:10.1016/j.jaad.2020.03.002
Yokogawa N, Vivino FB. Hydralazine-induced autoimmune disease: comparison to idiopathic lupus and ANCA-positive vasculitis. Mod Rheumatol. 2009;19(3):338–347. doi:10.1007/s10165-009-0168-y
Parodis I, Rovin BH, Tektonidou MG, Anders HJ, Malvar A, Mok CC, et al. Lupus nephritis. Nat Rev Dis Primers. 2025;11(1):69. doi:10.1038/s41572-025-00653-y
Katz U, Zandman-Goddard G. Drug-induced lupus: an update. Autoimmun Rev. 2010;10(1):46–50. doi:10.1016/j.autrev.2010.07.005
Lee AYS. Clinical use of anti-histone antibodies in idiopathic and drug-induced lupus. Immunol Med. 2022;45(4):180–185. doi:10.1080/25785826.2022.2060168
Ramos-Casals M, Brito-Zerón P, Muñoz S, Soria N, Galiana D, Bertolaccini L, et al. Autoimmune diseases induced by TNF-targeted therapies: analysis of 233 cases. Medicine (Baltimore). 2007;86(4):242–251. doi:10.1097/MD.0b013e3181441a68
Srivastava M, Rencic A, Diglio G, Santana H, Bonitz P, Watson R, et al. Drug-Induced, Ro/SSA-positive cutaneous lupus erythematosus. Arch Dermatol. 2003;139(1):45–49. doi:10.1001/archderm.139.1.45
Gonnet-Gracia C, Barnetche T, Richez C, Blanco P, Dehais J, Schaeverbeke T. Anti-nuclear antibodies, anti-DNA and C4 complement evolution in rheumatoid arthritis and ankylosing spondylitis treated with TNF-alpha blockers. Clin Exp Rheumatol. 2008 May-Jun;26(3):401-7. PMID: 18578960.
Vaz JL, Fernandes V, Nogueira F, Arnóbio A, Levy RA. Infliximab-induced autoantibodies: a multicenter study. Clin Rheumatol. 2016 Feb;35(2):325-32. doi: 10.1007/s10067-015-3140-6. Epub 2015 Dec 17. PMID: 26676808.
Wetter DA, Davis MDP. Lupus-like syndrome attributable to anti—tumor necrosis factor α therapy in 14 patients during an 8-year period at Mayo Clinic. Mayo Clin Proc. 2009;84(11):979–984. doi:https://doi.org/10.4065/84.11.979
Williams EL, Gadola S, Edwards CJ. Anti-TNF-induced lupus. Rheumatology (Oxford). 2009;48(7):716–720. doi:10.1093/rheumatology/kep080
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