Anti-TNF-α and hydralazine drug-induced lupus

Abstract

Drug-induced lupus is a rare drug reaction featuring the same symptoms as idiopathic lupus erythematosus. Recently, with the introduction of new medicines in clinical practice, an increase in the number of illness-triggering implicated drugs has been reported, with special emphasis on anti-TNF-α drugs. In the up-to-date list, almost one hundred medications have been associated with the occurrence of drug-induced lupus. The authors present two case reports of the illness induced respectively by hydralazine and infliximab, addressing the clinical and laboratorial characteristics, diagnosis, and treatment.

Drug-induced lupus erythematosus: an update on drugs and mechanisms

“…Systemic DILE induced by TNF-α inhibitors is well described in the literature and received widespread attention [17,[34][35][36][37], while PPI-induced SCLE is worth more awareness in clinical practice, as PPI-associated SCLE cases have been increasingly reported in a large scale. PPIs, often prescribed to treat peptic ulcer and gastroesophageal reflux disease (GERD), reduce gastric acid secretion by inhibiting the K+/H+ ATPase pump in gastric parietal cells [38].…”

Clinical features of tumor necrosis factor-α-inhibitor induced chilblain lupus: A case series

“…One hypothesis is that TNF-α inhibitors interfere with cell apoptosis, leading to decreased clearance of nuclear debris and development of autoantibodies. 2 , 13 Another explanation is that TNF-α inhibitors block TH1 cytokine production, causing increased levels of TH2 cytokines and autoantibodies. 2 , 13 A third mechanism suggests that TNF-α inhibitors block cytotoxic T cells, reducing their ability to clear autoantibodies produced by B cells.…”

“… 2 , 13 Another explanation is that TNF-α inhibitors block TH1 cytokine production, causing increased levels of TH2 cytokines and autoantibodies. 2 , 13 A third mechanism suggests that TNF-α inhibitors block cytotoxic T cells, reducing their ability to clear autoantibodies produced by B cells. 7 , 13 Finally, as bacterial infections are increased with TNF-α inhibitors, this may lead to polyclonal B cell activation and autoantibody formation.…”

Mortalidade De Pedestres Em Acidentes De Trânsito No Brasil Durante O Período De 2010 a 2017: Um Estudo Ecológico De Série Temporal

“…Os medicamentosa imunobiológicos vem modificando a realidade de muitas doenças auto-imunes, como psoríase, artrite reumatóide, entre outras [ SHOYMAN, 2017]. Nessa classe, ocorre destaque para as terapias anti-TNF (infliximab, etanercept e adalimumab) [BORUCKI, 2019;QUARESMA, 2015;STEIN, 2018;VEDOVE, 2012]. Vários outros agentes biológicos vem sendo descritos em relatos de caso, como anti-CLTA4, anti-IL17 e anti IL12/23 [BORUCKI, 2019;TIERNEY, 2019TARAZI, 2018WEHRMANN, 2018].…”