Drug-Induced Lupus: Causes, Symptoms, Diagnosis and Management

Lupus, a complex autoimmune disease, can sometimes be triggered by medications. This variant, known as drug-induced lupus, shares similarities with systemic lupus erythematosus (SLE) but has distinct features. Let’s delve into this condition’s causes, symptoms, diagnosis, and treatment options. 

Causes of Drug-Induced Lupus

• Medications: Drug-induced lupus occurs due to a reaction to specific prescription drugs. While no single test can diagnose it, certain medications are commonly associated with this condition. 
• Common Culprits:
  – Hydralazine: Used to treat high blood pressure.
  – Procainamide: Used for irregular heart rhythms. 
  – Quinidine: Also used for irregular heart rhythms. 
  – Other drugs: Such as antibiotics, anticonvulsants, and hormones, may also contribute.^{1 2}
• “The most common medicines known to cause drug-induced lupus erythematosus are:
  – Isoniazid
  – Hydralazine
  – Procainamide
  – Tumor necrosis factor (TNF) alpha inhibitors (such as etanercept, infliximab and adalimumab) 
  – Minocycline
  – Quinidine
  – Other less common drugs may also cause the condition. These may include: 
  – Anti-seizure medicines 
  – Capoten 
  – Chlorpromazine 
  – Methyldopa 
  – Sulfasalazine 
  – Levamisole, typically as a contaminant of cocaine 
  – Cancer immunotherapy drugs such as pembrolizumab can also cause a variety of autoimmune reactions including drug-induced lupus. 
  – Symptoms of drug-induced lupus tend to occur after taking the drug for at least 3 to 6 months.”
  (https://medlineplus.gov/ency/article/000446.htm)

Symptoms of Drug-Induced Lupus

Similar to regular lupus (SLE):

• Muscle pain. 
• Joint pain, sometimes with swelling. 
• Fever. 
• Fatigue. 
• Weight loss. 
• Inflammation around the lungs or heart causing discomfort. 
• Symptoms typically appear after several months to years of continuous medication use.^{3 5 6}

Diagnosis of Drug-Induced Lupus

• Physical Examination: 
  – Swollen and tender joints. 
  – Skin rashes. 
• Laboratory Tests:
  – Antinuclear Antibody (ANA) Test: Detects immune system stimulation.
  – Complete Blood Count (CBC): Reveals anemia and abnormal white blood cell or platelet counts.
  – Erythrocyte Sedimentation Rate (ESR): Measures inflammation.
  – Kidney and Liver Assessment: Evaluates organ function.
  – Urinalysis: Detects kidney involvement.
  – Biopsy: May be necessary to assess kidney damage
• Imaging Tests: 
  – Chest X-ray: Checks for lung inflammation. 
  – Echocardiogram: Assesses heart function. 
• Skin Biopsy: Confirms skin-related lupus.^{3 8}

Treatment Options for Drug-Induced Lupus

• Discontinuation of Causative Medication: Drug-induced lupus is usually temporary. Symptoms often clear up within weeks to months after stopping the offending drug. 
• Managing Symptoms: 
  – Pain relief (NSAIDs). 
  – Corticosteroids for inflammation. 
  – Immunosuppressive drugs 
• Holistic Approaches: 
  – Full body detox: Helping the body release the toxicity from meds can speed up recovery as well as address other underlying drivers for dis-ease that created the need for meds in the first place. Find a Functional Medicine Practitioner to help you with this.  
  – Diet: using food sensitivity testing to pinpoint exactly what foods the client is causing an inflammatory response and what foods are not, is a critical step to the successful resolution of medication-induced Lupus. Recommended testing available to the public.  
  * Food Sensitivity Testing Profile 1
  * Food Sensitivity Complete 
  – Stress Management: Stress exacerbates symptoms.  
  – Exercise: Gentle physical activity. 
  – Sun Protection: Wearing a hat and long sleeves can minimize sun exposure until symptoms resolve. 
• Recovery Rates: 
  – Most cases improve significantly after discontinuing the medication. 
  – Rarely, symptoms persist even after stopping the drug

Conclusion

Drug-induced lupus presents unique challenges, but early diagnosis, prompt cessation of the causative medication, and holistic self-care can lead to positive outcomes. If you suspect drug-induced lupus, consult a healthcare professional for personalized guidance.^{1 3 8}

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Source(s):

1. Drug-Induced Lupus: Causes, Symptoms, Diagnosis – WebMD 
2. Drug-induced lupus: Symptoms, causes, treatments, and FAQs 
3. Medication-Induced Lupus Symptoms and Treatment – Verywell Health 
4. Lupus – Symptoms & causes – Mayo Clinic 
5. Medications that can cause drug-induced lupus 
6. Drug Induced Lupus: What Is It and Are You At Risk? – Healthline 
7. Symptoms of Drug-Induced Lupus | Lupus Canada 
8. What is drug-induced lupus? | Lupus Foundation of America 
9. Drug-induced lupus erythematosus – MedlinePlus 
10. Lupus – Diagnosis & treatment – Mayo Clinic 
11. en.wikipedia.org