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Chlorpromazine-induced lupus with cardiac tamponade
B L Jonas1, M Lim, C A Agudelo
1Department of Medicine/Rheumatology, VA Medical Center and Emory University, Atlanta, Georgia.
Summary
Chlorpromazine, a phenothiazine, can induce lupus erythematosus, a rare but serious condition. This case highlights the importance of monitoring patients for drug-induced lupus, especially when cardiac tamponade occurs.
Area of Science:
- Immunology
- Cardiology
- Pharmacology
Background:
- Phenothiazines are known to cause immunologic abnormalities.
- Clinical lupus erythematosus associated with phenothiazines is infrequently reported.
- Chronic chlorpromazine use is common in psychiatric treatment.
Purpose of the Study:
- To report a rare case of drug-induced lupus erythematosus.
- To highlight the potential for cardiac complications in drug-induced lupus.
- To emphasize the importance of recognizing and managing this condition.
Main Methods:
- Case report of a 52-year-old male patient.
- Analysis of clinical presentation, including fever and pleuropericarditis with cardiac tamponade.
- Laboratory examination of pleural and pericardial fluids for anti-nuclear antibodies.
Main Results:
- The patient developed symptoms consistent with lupus erythematosus during chlorpromazine therapy.
- Anti-nuclear antibodies were detected in pleural and pericardial fluids.
- The patient's condition improved with steroid treatment and chlorpromazine discontinuation.
Conclusions:
- Chlorpromazine can induce a lupus-like syndrome, including potentially life-threatening cardiac tamponade.
- Drug-induced lupus is generally self-limiting upon medication withdrawal.
- Close patient observation is crucial to detect and manage severe complications like cardiac tamponade.
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