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Hydralazine-induced lupus and vocal fold paralysis
C K Hari1, S A Raza, M I Clayton
1Department of Otolaryngology and Head and Neck Surgery, Royal Gwent Hospital, Newport, U.K.
The Journal of Laryngology and Otology
|January 7, 1999
Summary
Hydralazine can induce a lupus-like syndrome affecting the upper airway. In a case study, stopping hydralazine reversed acute laryngeal edema and vocal fold paralysis in a patient with drug-induced lupus.
Area of Science:
- Immunology
- Otolaryngology
- Pharmacology
Background:
- Systemic lupus erythematosus (SLE) is a complex autoimmune disease impacting multiple organ systems.
- Drug-induced lupus erythematosus (DILE) can mimic idiopathic SLE, with various medications implicated.
- Hydralazine is a known trigger for drug-induced lupus erythematosus.
Observation:
- A patient presented with acute upper airway obstruction due to laryngeal edema.
- Concurrent right vocal fold paralysis was noted, suggesting neurological involvement.
- The patient's medical history revealed recent initiation of hydralazine therapy.
Findings:
- The clinical presentation was consistent with hydralazine-induced lupus.
- Laryngeal edema and vocal fold paralysis resolved following discontinuation of hydralazine.
- This case highlights the potential for hydralazine to cause significant upper airway manifestations.
Implications:
- Early recognition of hydralazine-induced lupus is crucial for prompt management.
- Discontinuation of the offending agent is key to reversing drug-induced lupus symptoms.
- Awareness of DILE is important for otolaryngologists and physicians managing patients on hydralazine.