Drugs Recently Associated With Lupus Syndromes

Abstract

A number of drugs have recently been implicated in a syndrome that resembles systemic lupus erythematosus. One of the difficulties in many of these patients is that the signs, symptoms and serological abnormalities reported in these patients may be a natural consequence of the primary diseases rather than the incriminated drug. A second problem with the studies is a lack of uniform reporting of the techniques used to detect autoantibodies. For example, a patient that has a highly positive ANA with a homogeneous pattern of staining or a positive LE cell test usually has antibodies directed against chromatin components (DNA, histones, high mobility group (HMG) proteins). The discrepancies in clinical criteria and the serological techniques in many of these reports, emphasize the importance of using guidelines for the diagnosis of drug-induced or drug-related lupus. In the future, it appears that the increased use of biological response modifiers such as interferon-alpha and other cytokines may prompt more reports of lupus syndromes associated with their use.

Activation of Natural Interferon-α Producing Cells by Apoptotic U937 Cells Combined with Lupus IgG and its Regulation by Cytokines

“…Among studied cytokines, IFN-can be detected in the majority of SLE patients with active disease and levels reflect disease activity [3][4][5][6]. The increased IFNproduction in SLE patients may be important in the pathogenesis, because IFN-treatment of patients with non-autoimmune diseases can induce both anti-DNA antibodies and occasionally an SLE syndrome [7][8][9][10].…”

Anti-nuclear antibodies and the optic-spinal form of multiple sclerosis

“…Any patient being treated with an immunosuppressive drug or steroids during the month before blood sampling was excluded from this study. Twelve patients (4 with OpS-MS, 8 other MS patients) had anticonvulsant medication which might induce serum ANA positivity [6] during the month before blood sampling. The disability status of the patients at the time of blood sampling was scored according to Kurtzke's Expanded Disability Status Scale (EDSS) [21].…”

Factores de riesgo relacionados con lupus eritematoso sistémico en población mexicana

“…33 Se ha descrito la asociación de LES principalmente con el uso de fármacos antihipertensivos, anticonvulsivantes, antifímicos y antibióticos. [21][22][23][24] Sin embargo, en estudios epidemiológicos previos [25][26][27][28][29][30][31] no se había evaluado esta variable. En nuestro estudio hubo un riesgo cinco veces mayor (RM 5.0, IC 95%1.6-21.6) al evaluar en conjunto el antecedente de uso a dosis convencionales de isoniazida, alfametildopa o carbamazepina y no hubo asociación con el uso de otros medicamentos.…”

“…La frecuencia de LES en gemelos monocigotos es de 25% comparada con 2% en gemelos dicigotos; 1,2 aunque esto sugiere un papel importante de la herencia en el desarrollo de LES, [3][4][5][6][7] el factor genético por sí solo no explica la etiología de la enfermedad. Otros factores de riesgo, incluyendo endócrinos, [8][9][10][11][12] ambientales, [13][14][15][16][17] infecciosos 18-20 y fármacos [21][22][23][24] pueden actuar sinérgicamente en el desarrollo de LES en un huésped genéticamente susceptible.…”