Drug-induced lupus syndrome
Galyna Cordero, QPPV, Head of pharmacovigilance department, clinical expert JSC”Farmak”
Abstract
Drug-induced lupus syndrome (DILS) is an autoimmune condition characterized by symptoms similar to those of systemic lupus erythematosus (SLE), but triggered by certain medications. Unlike SLE, DILS is generally reversible upon discontinuation of the offending drug. This article reviews the pathophysiology, clinical manifestations, diagnostic criteria, and management strategies for DILS.
Pathophysiologically, DILS is believed to result from an interplay of genetic predisposition and drug-induced immune modulation, leading to autoantibody production. Clinically, patients often present with symptoms such as arthralgia, myalgia, fever, and serositis, with less frequent involvement of renal and central nervous systems compared to SLE.
Diagnosis is primarily clinical, supported by the temporal association with drug exposure and the presence of specific autoantibodies, such as antihistone antibodies. Key drugs implicated in DILS include procainamide, hydralazine, and certain TNF-α inhibitors.
Management involves discontinuation of the offending drug, which usually leads to resolution of symptoms. In some cases, corticosteroids or immunosuppressive agents may be required to control severe manifestations.
In conclusion, awareness and timely identification of DILS are crucial for effective management and prevention of long-term complications. Further research is needed to elucidate the underlying mechanisms and to develop targeted therapies for those with severe or persistent disease
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