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Systemic lupus erythematosus induced by isoniazid
M Salazar-Páramo1, R L Rubin, I García-De La Torre
1Department of Immunology and Rheumatology, Hospital General de Occidente de la S.S., Zapopan, Jalisco, Mexico.
Annals of the Rheumatic Diseases
|September 1, 1992
Summary
Isoniazid treatment can trigger a lupus-like illness in patients, causing specific autoantibodies against the nucleo-histone complex. Discontinuing the drug and using prednisone resolved symptoms and reduced antibody levels.
Area of Science:
- Immunology
- Rheumatology
- Pharmacology
Background:
- Drug-induced lupus erythematosus (DILE) is a condition mimicking systemic lupus erythematosus, often triggered by medications.
- Isoniazid, a primary treatment for tuberculosis, has been anecdotally linked to DILE.
- Specific autoantibody profiles can aid in diagnosing drug-induced autoimmune conditions.
Observation:
- A 73-year-old man developed a lupus-like syndrome during isoniazid therapy.
- The patient exhibited IgG antinuclear antibodies targeting the nucleo-histone complex (H2A-H2B)-DNA.
- Clinical symptoms included typical lupus erythematosus manifestations.
Findings:
- Discontinuation of isoniazid therapy led to the resolution of the patient's lupus-like symptoms.
- A short course of prednisone treatment was administered.
- Antibody levels against the nucleo-histone complex (H2A-H2B)-DNA gradually decreased following treatment cessation and prednisone use.
Implications:
- This case highlights isoniazid as a potential inducer of specific autoantibody production in drug-related lupus.
- The findings suggest a direct causal link between isoniazid exposure and the development of a particular autoimmune response.
- Understanding drug-specific antibody profiles can improve the diagnosis and management of drug-induced lupus.