Fulminating hydralazine‐induced lupus pneumonitis

Birnbaum, Belinda K.; Sidhu, Gurdip S.; Smith, Robert L.; Pillinger, Michael H.; Tagoe, Clément E.

doi:10.1002/art.21987

Cited by 12 publications

(11 citation statements)

References 19 publications

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“…Procainamideassociated lung injury has also been described independently and as part of a group of symptoms classified as drug-induced lupus (DIL) [3,10]. DIL differs significantly from systemic lupus erythematosus (SLE) and occurs in 20-30% of patients on long-term procainamide therapy [14,15]. Traditional cutaneous manifestations of lupus, such as malar rash, discoid rash, photosensitivity, alopecia, or mucosal ulcerations, are rarely encountered with DIL [13].…”

Section: Discussionmentioning

confidence: 98%

Procainamide-induced pulmonary fibrosis after orthotopic heart transplantation: a case report and literature review

Thangam

Nathan

Petrovica

et al. 2015

Cardiovascular Pathology

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Section: Discussionmentioning

confidence: 98%

Procainamide-induced pulmonary fibrosis after orthotopic heart transplantation: a case report and literature review

Thangam

Nathan

Petrovica

et al. 2015

Cardiovascular Pathology

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“…1 Renal biopsy 9400 magnification, stained with silver. Focal necrotising capillaritis occur [4][5][6]. Renal involvement directly attributable to the condition is rare, but when present, it is histopathologically consistent with lupus nephritis with deposition of immune complexes, immunoglobulin and complement [6].…”

Section: Imagingmentioning

confidence: 96%

Combined ANCA-associated vasculitis and lupus syndrome following prolonged use of hydralazine: a timely reminder of an old foe

et al. 2009

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“… 7 However, pleuritic chest pain was a feature of 25% of 44 hydralazine‐induced lupus patients in one series of patients, 5 and serositis was described in 6 of 21 (29%) patients in another series 6 . Fever was a solitary clinical feature in 5 of 44 patients, 5 and was 105°F in one case report 8 . Lymphadenopathy may be noted on physical examination 5,9 as well as hepatosplenomegaly 4 …”

Section: What Are the Common Clinical Features?mentioning

confidence: 97%

Hydralazine‐Induced Lupus Erythematosis

Handler

2011

J of Clinical Hypertension

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A 65-year-old woman was seen in our hypertension clinic following recovery from hydralazine-induced lupus erythematosis. She had been taking antihypertensive medication for 15 years and was evaluated by the rheumatology department a year prior to her hypertension consultation for joint pain and swelling associated with positive serologies.A month prior to her rheumatology appointment she developed acute pain and swelling in the left fifth proximal interphalangeal joint (PIP), followed by painful swelling of the fourth and fifth PIP joints allowing minimal flexion. Subsequent joint involvement progressed to the right fifth PIP joint, bilateral wrists, right shoulder, bilateral knees, bilateral ankles, and both forefeet. Laboratory tests were significant for a diffuse pattern antinuclear antibody 1:2560 and a low positive rheumatoid factor of 17 IU ⁄ mL (normal <11 IU ⁄ mL). A complete blood cell count and renal function were normal. She denied fever, rash, pleuritic chest pain, or shortness of breath.Rheumatology examination noted swelling and tenderness of the left third, fourth, and fifth PIP joints with dactylitis, swelling and tenderness of the right fifth PIP, and bilateral tender wrists. Additional serologies revealed antidouble stranded deoxyribonucleic acid antibody (anti-ds DNA ab) 15 IU ⁄ mL (normal <25.0 IU ⁄ mL), antihistone antibody 1.8 UOM ⁄ U (normal <1.0 UOM ⁄ U), C3 complement 153 mg ⁄ dL (normal 90-180 mg ⁄ dL), C4 complement 21 mg ⁄ dL (normal 10-40 mg ⁄ dL), and Westergren erythrocyte sedimentation rate 43 mm ⁄ h (normal 0-33 mm ⁄ h). Her 4-drug antihypertensive drug regimen included hydralazine 50 mg twice a day for 5 years.Hydralazine was discontinued and azulfidine was initiated and advanced to 1000 mg twice a day with meloxicam 15 mg daily. Painful joints rapidly abated and 6 months later azulfidine was discontinued without a recurrence of her inflammatory arthritis. Losartan, amlodipine, and atenolol were continued. When chlorthalidone was substituted for furosemide, elevated blood pressures off of hydralazine became controlled.

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Fulminating hydralazine‐induced lupus pneumonitis

Cited by 12 publications

References 19 publications

Procainamide-induced pulmonary fibrosis after orthotopic heart transplantation: a case report and literature review

Procainamide-induced pulmonary fibrosis after orthotopic heart transplantation: a case report and literature review

Combined ANCA-associated vasculitis and lupus syndrome following prolonged use of hydralazine: a timely reminder of an old foe

Hydralazine‐Induced Lupus Erythematosis

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