[Drug-induced lupus erythematosus and systemic lupus erythematosus--differences and similarities]

Drug-induced lupus (DIL) is a lupus-like syndrome. Its clinical and laboratory features are very similar to idiopathic lupus. First description of DIL is from 1945. Since that time over 80 medications are known to be responsible for development of the disease. Nevertheless mechanisms responsible for this process are not known enough. Nowadays direct and indirect mechanisms in DIL are known. The slow acetylator status has an important position. Moreover the role of estrogens and anti-TNF-alpha therapy are taken into consideration. The T cells' participation and the methylation of DNA and their role in graft-vs.-host disease, which is the murine model for DIL, are considered among others. Researches point also to the LFA-1 and the IL-6 as factors responsible for DIL's development. Another element which could be significant in this process is the presence of antimielo-peroxydase antibodies. Also the role of disruption of T-cell maturation in the thymus induced by the drugs' metabolites may have an important position. Nevertheless it is still very hard to say which of those mechanisms is the main one. In spite of everything it's not clear enough if the observed clinical manifestations are caused by drugs/their metabolites,- DIL or that they are consequences of a induction of silent process leading to SLE development.