BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuDrug-induced lupus erythematosusLupus - drug inducedDrug-induced lupus erythematosus is an autoimmune disorder that is triggered by a reaction to a medicine.Autoimmune disorderAn autoimmune disorder occurs when the body's immune system attacks and destroys healthy body tissue by mistake. There are more than 80 autoimmune d...ImageRead Article Now Book Mark Article Causes Drug-induced lupus erythematosus is similar but not identical to systemic lupus erythematosus (SLE). It is an autoimmune disorder. This means your body attacks healthy tissue by mistake. It is caused by a reaction to a medicine. Related conditions are drug-induced cutaneous lupus and drug-induced ANCA vasculitis.Systemic lupus erythematosusSystemic lupus erythematosus (SLE) is an autoimmune disease. In this disease, the immune system of the body mistakenly attacks healthy tissue. It c...ImageRead Article Now Book Mark Article 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 QuinidineOther less common drugs may also cause the condition. These may include:Anti-seizure medicines Capoten Chlorpromazine Methyldopa Sulfasalazine Levamisole, typically as a contaminant of cocaineCancer 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. Symptoms Symptoms may include:Fever FeverFever is the temporary increase in the body's temperature in response to a disease or illness. A child has a fever when the temperature is at or abov...ImageRead Article Now Book Mark Article General ill feeling (malaise) Joint pain Joint painJoint pain can affect one or more joints.ImageRead Article Now Book Mark Article Joint swelling Joint swellingJoint swelling is the buildup of fluid in the soft tissue surrounding the joint or the joint itself.ImageRead Article Now Book Mark Article Loss of appetite Pleuritic chest pain (sharp pain that is worse with breathing in) PleuriticPleurisy is an inflammation of the lining of the lungs and chest (the pleura) that leads to chest pain when you take a breath or cough.ImageRead Article Now Book Mark Article Skin rash on areas exposed to sunlightSkin rashRashes involve changes in the color, feeling or texture of your skin.ImageRead Article Now Book Mark Article Exams and Tests The health care provider will do a physical exam and listen to your chest with a stethoscope. The provider may hear a sound called a heart friction rub or pleural friction rub.A skin exam shows a rash.Joints may be swollen and tender.JointsJoint pain can affect one or more joints.ImageRead Article Now Book Mark Article Tests that may be done include:Antihistone antibody Antinuclear antibody (ANA) panel Antinuclear antibody (ANA) panelThe antinuclear antibody panel is a blood test that looks at antinuclear antibodies (ANA). ANA are antibodies produced by the immune system that bind...ImageRead Article Now Book Mark Article Antineutrophil cytoplasmic antibody (ANCA) panel Complete blood count (CBC) with differential Complete blood count (CBC)A complete blood count (CBC) test measures the following:The number of white blood cells (WBC count)The number of red blood cells (RBC count)The numb...ImageRead Article Now Book Mark Article Comprehensive chemistry panel UrinalysisUrinalysisUrinalysis is the physical, chemical, and microscopic examination of urine. It involves a number of tests to detect and measure various compounds th...ImageRead Article Now Book Mark Article A chest x-ray may show signs of pleuritis or pericarditis (inflammation around the lining of the lung or heart). An ECG may show that the heart is affected.Chest x-rayA chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.ImageRead Article Now Book Mark Article ECGAn electrocardiogram (ECG) is a test that records the electrical activity of the heart.ImageRead Article Now Book Mark Article Treatment Most of the time, symptoms go away within weeks after stopping the medicine that caused the condition.Treatment may include:Nonsteroidal anti-inflammatory drugs (NSAIDs) to treat arthritis and pleurisy Corticosteroid creams to treat skin rashes Antimalarial drugs (hydroxychloroquine) to treat skin and arthritis symptomsIf the condition is affecting your heart, kidney, or nervous system, you may be prescribed high doses of corticosteroids (prednisone, methylprednisolone) and immune system suppressants (azathioprine or cyclophosphamide). This is rare.When the disease is active, you should wear protective clothing and sunglasses to guard against too much sun. Outlook (Prognosis) Most of the time, drug-induced lupus erythematosus is not as severe as SLE. The symptoms often go away within a few days to weeks after stopping the medicine you were taking. Rarely, kidney inflammation (nephritis) can develop with drug-induced lupus caused by TNF inhibitors or with ANCA vasculitis due to hydralazine or levamisole. Nephritis may require treatment with prednisone and immunosuppressive medicines.Avoid taking the drug that caused the reaction in future. Symptoms are likely to return if you do so. Possible Complications Complications may include:Infection Thrombocytopenic purpura -- bleeding near the skin surface, resulting from a low number of platelets in the blood ThrombocytopenicThrombocytopenia means there is an abnormally low amount of platelets. Platelets are parts of the blood that help blood to clot. This condition is ...Read Article Now Book Mark Article Hemolytic anemia Hemolytic anemiaAnemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues. Normally, red ...ImageRead Article Now Book Mark Article Myocarditis MyocarditisMyocarditis is inflammation of the heart muscle. The condition is called pediatric myocarditis when it occurs in children.ImageRead Article Now Book Mark Article Pericarditis PericarditisPericarditis is a condition in which the sac-like covering around the heart (pericardium) becomes inflamed.ImageRead Article Now Book Mark Article Nephritis When to Contact a Medical Professional Contact your provider if:You develop new symptoms when taking any of the medicines listed above. Your symptoms do not get better after you stop taking the medicine that caused the condition. Prevention Watch for signs of a reaction if you are taking any of the drugs that can cause this problem.Open ReferencesReferencesBenfaremo D, Manfredi L, Luchetti MM, Gabrielli A. Musculoskeletal and rheumatic diseases induced by immune checkpoint inhibitors: a review of the literature. Curr Drug Saf. 2018;13(3):150-164. PMID: 29745339 pubmed.ncbi.nlm.nih.gov/29745339/.Radhakrishnan J, Perazella MA. Drug-induced glomerular disease: attention required. Clin J Am Soc Nephrol. 2015;10(7):1287-1290. PMID: 25876771 pubmed.ncbi.nlm.nih.gov/25876771/.Richardson B. Drug-induced lupus. In: Hochberg MC, Gravallese EM, Smolen JS, van der Heijde D, Weinblatt ME, Weisman MH, eds. Rheumatology. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 140.Rubin RL. Drug-induced lupus. Expert Opin Drug Saf. 2015;14(3):361-378. PMID: 25554102 pubmed.ncbi.nlm.nih.gov/25554102/.Vaglio A, Grayson PC, Fenaroli P, et al. Drug-induced lupus: traditional and new concepts. Autoimmun Rev. 2018;17(9):912-918. PMID: 30005854 pubmed.ncbi.nlm.nih.gov/30005854/.AllVideoImagesTogLupus, discoid - view of lesions on the chest - illustration This close-up picture of the neck clearly shows the typical rounded appearance of discoid lupus. The whitish appearance is caused by scaling. The two dark spots are biopsy sites and are not part of the disease.Lupus, discoid - view of lesions on the chestillustrationAntibodies - illustration Antigens are large molecules (usually proteins) on the surface of cells, viruses, fungi, bacteria, and some non-living substances such as toxins, chemicals, drugs, and foreign particles. The immune system recognizes antigens and produces antibodies that destroy substances containing antigens. AntibodiesillustrationLupus, discoid - view of lesions on the chest - illustration This close-up picture of the neck clearly shows the typical rounded appearance of discoid lupus. The whitish appearance is caused by scaling. The two dark spots are biopsy sites and are not part of the disease.Lupus, discoid - view of lesions on the chestillustrationAntibodies - illustration Antigens are large molecules (usually proteins) on the surface of cells, viruses, fungi, bacteria, and some non-living substances such as toxins, chemicals, drugs, and foreign particles. The immune system recognizes antigens and produces antibodies that destroy substances containing antigens. AntibodiesillustrationA Closer Look Systemic lupus erythematosus - InDepth(In-Depth)Hepatitis - InDepth(In-Depth)Bipolar disorder - InDepth(In-Depth)Scleroderma - InDepth(In-Depth)Restless legs syndrome and related disorders - InDepth(In-Depth)Cirrhosis - InDepth(In-Depth)Anemia - InDepth(In-Depth) Tests for Drug-induced lupus erythematosus Antinuclear antibody panelRelated Information Autoimmune disorders(Condition)Systemic lupus erythematosus(Condition)Chronic(Special Topic)Immune response(Special Topic)Antibody(Special Topic)Arthritis(Condition)Systemic(Special Topic)Lupus nephritis(Condition)Hemolytic anemia(Condition)Myocarditis(Condition)Systemic lupus erythematosus - InDepth(In-Depth)Osteoarthritis - InDepth(In-Depth) Review Date: 4/30/2023 Reviewed By: Neil J. Gonter, MD, Assistant Professor of Medicine, Columbia University, New York, NY, and private practice specializing in Rheumatology at Rheumatology Associates of North Jersey, Teaneck, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited. © 1997- All rights reserved. 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Drug-induced lupus erythematosusLupus - drug inducedDrug-induced lupus erythematosus is an autoimmune disorder that is triggered by a reaction to a medicine.Autoimmune disorderAn autoimmune disorder occurs when the body's immune system attacks and destroys healthy body tissue by mistake. There are more than 80 autoimmune d...ImageRead Article Now Book Mark Article Causes Drug-induced lupus erythematosus is similar but not identical to systemic lupus erythematosus (SLE). It is an autoimmune disorder. This means your body attacks healthy tissue by mistake. It is caused by a reaction to a medicine. Related conditions are drug-induced cutaneous lupus and drug-induced ANCA vasculitis.Systemic lupus erythematosusSystemic lupus erythematosus (SLE) is an autoimmune disease. In this disease, the immune system of the body mistakenly attacks healthy tissue. It c...ImageRead Article Now Book Mark Article 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 QuinidineOther less common drugs may also cause the condition. These may include:Anti-seizure medicines Capoten Chlorpromazine Methyldopa Sulfasalazine Levamisole, typically as a contaminant of cocaineCancer 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. Symptoms Symptoms may include:Fever FeverFever is the temporary increase in the body's temperature in response to a disease or illness. A child has a fever when the temperature is at or abov...ImageRead Article Now Book Mark Article General ill feeling (malaise) Joint pain Joint painJoint pain can affect one or more joints.ImageRead Article Now Book Mark Article Joint swelling Joint swellingJoint swelling is the buildup of fluid in the soft tissue surrounding the joint or the joint itself.ImageRead Article Now Book Mark Article Loss of appetite Pleuritic chest pain (sharp pain that is worse with breathing in) PleuriticPleurisy is an inflammation of the lining of the lungs and chest (the pleura) that leads to chest pain when you take a breath or cough.ImageRead Article Now Book Mark Article Skin rash on areas exposed to sunlightSkin rashRashes involve changes in the color, feeling or texture of your skin.ImageRead Article Now Book Mark Article Exams and Tests The health care provider will do a physical exam and listen to your chest with a stethoscope. The provider may hear a sound called a heart friction rub or pleural friction rub.A skin exam shows a rash.Joints may be swollen and tender.JointsJoint pain can affect one or more joints.ImageRead Article Now Book Mark Article Tests that may be done include:Antihistone antibody Antinuclear antibody (ANA) panel Antinuclear antibody (ANA) panelThe antinuclear antibody panel is a blood test that looks at antinuclear antibodies (ANA). ANA are antibodies produced by the immune system that bind...ImageRead Article Now Book Mark Article Antineutrophil cytoplasmic antibody (ANCA) panel Complete blood count (CBC) with differential Complete blood count (CBC)A complete blood count (CBC) test measures the following:The number of white blood cells (WBC count)The number of red blood cells (RBC count)The numb...ImageRead Article Now Book Mark Article Comprehensive chemistry panel UrinalysisUrinalysisUrinalysis is the physical, chemical, and microscopic examination of urine. It involves a number of tests to detect and measure various compounds th...ImageRead Article Now Book Mark Article A chest x-ray may show signs of pleuritis or pericarditis (inflammation around the lining of the lung or heart). An ECG may show that the heart is affected.Chest x-rayA chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.ImageRead Article Now Book Mark Article ECGAn electrocardiogram (ECG) is a test that records the electrical activity of the heart.ImageRead Article Now Book Mark Article Treatment Most of the time, symptoms go away within weeks after stopping the medicine that caused the condition.Treatment may include:Nonsteroidal anti-inflammatory drugs (NSAIDs) to treat arthritis and pleurisy Corticosteroid creams to treat skin rashes Antimalarial drugs (hydroxychloroquine) to treat skin and arthritis symptomsIf the condition is affecting your heart, kidney, or nervous system, you may be prescribed high doses of corticosteroids (prednisone, methylprednisolone) and immune system suppressants (azathioprine or cyclophosphamide). This is rare.When the disease is active, you should wear protective clothing and sunglasses to guard against too much sun. Outlook (Prognosis) Most of the time, drug-induced lupus erythematosus is not as severe as SLE. The symptoms often go away within a few days to weeks after stopping the medicine you were taking. Rarely, kidney inflammation (nephritis) can develop with drug-induced lupus caused by TNF inhibitors or with ANCA vasculitis due to hydralazine or levamisole. Nephritis may require treatment with prednisone and immunosuppressive medicines.Avoid taking the drug that caused the reaction in future. Symptoms are likely to return if you do so. Possible Complications Complications may include:Infection Thrombocytopenic purpura -- bleeding near the skin surface, resulting from a low number of platelets in the blood ThrombocytopenicThrombocytopenia means there is an abnormally low amount of platelets. Platelets are parts of the blood that help blood to clot. This condition is ...Read Article Now Book Mark Article Hemolytic anemia Hemolytic anemiaAnemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues. Normally, red ...ImageRead Article Now Book Mark Article Myocarditis MyocarditisMyocarditis is inflammation of the heart muscle. The condition is called pediatric myocarditis when it occurs in children.ImageRead Article Now Book Mark Article Pericarditis PericarditisPericarditis is a condition in which the sac-like covering around the heart (pericardium) becomes inflamed.ImageRead Article Now Book Mark Article Nephritis When to Contact a Medical Professional Contact your provider if:You develop new symptoms when taking any of the medicines listed above. Your symptoms do not get better after you stop taking the medicine that caused the condition. Prevention Watch for signs of a reaction if you are taking any of the drugs that can cause this problem.Open ReferencesReferencesBenfaremo D, Manfredi L, Luchetti MM, Gabrielli A. Musculoskeletal and rheumatic diseases induced by immune checkpoint inhibitors: a review of the literature. Curr Drug Saf. 2018;13(3):150-164. PMID: 29745339 pubmed.ncbi.nlm.nih.gov/29745339/.Radhakrishnan J, Perazella MA. Drug-induced glomerular disease: attention required. Clin J Am Soc Nephrol. 2015;10(7):1287-1290. PMID: 25876771 pubmed.ncbi.nlm.nih.gov/25876771/.Richardson B. Drug-induced lupus. In: Hochberg MC, Gravallese EM, Smolen JS, van der Heijde D, Weinblatt ME, Weisman MH, eds. Rheumatology. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 140.Rubin RL. Drug-induced lupus. Expert Opin Drug Saf. 2015;14(3):361-378. PMID: 25554102 pubmed.ncbi.nlm.nih.gov/25554102/.Vaglio A, Grayson PC, Fenaroli P, et al. Drug-induced lupus: traditional and new concepts. Autoimmun Rev. 2018;17(9):912-918. PMID: 30005854 pubmed.ncbi.nlm.nih.gov/30005854/.