Hydralazine-induced autoimmune disease: comparison to idiopathic lupus and ANCA-positive vasculitis

Yokogawa, Naoto; Vivino, Frederick B.

doi:10.1007/s10165-009-0168-y

Cited by 60 publications

(85 citation statements)

References 34 publications

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“…Evidence for hydralazine-associated vasculitis dates to the pre-ANCA era, including rapidly progressive GN. A 2009 review of the literature found 68 hydralazine vasculitis reports (mean duration of drug exposure 54.7 years; mean dose 5142 mg/d) (38). Similar to the findings by Choi et al (5), kidney disease was common on presentation (81%), and patients had additional serologic evidence of an autoimmune process (96% ANA positive, 26% anti-dsDNA antibody positive, and 44% hypocomplementemia).…”

Section: Drugs Associated With Aavsupporting

confidence: 67%

Drug-Induced Glomerular Disease

Hogan

Markowitz²,

Radhakrishnan

2015

Clinical Journal of the American Society of Nephrology

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Drug-induced autoimmune disease was initially described decades ago, with reports of vasculitis and a lupus-like syndrome in patients taking hydralazine, procainamide, and sulfadiazine. Over the years, multiple other agents have been linked to immune-mediated glomerular disease, often with associated autoantibody formation. Certain clinical and laboratory features may distinguish these entities from their idiopathic counterparts, and making this distinction is important in the diagnosis and management of these patients. Here, drug-induced, ANCA-associated vasculitis, drug-induced lupus, and drug-associated membranous nephropathy are reviewed.

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Section: Drugs Associated With Aavsupporting

confidence: 67%

Drug-Induced Glomerular Disease

Hogan

Markowitz²,

Radhakrishnan

2015

Clinical Journal of the American Society of Nephrology

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“…Hydralazine-induced vasculitis mimics idiopathic anti-neutrophil cytoplasmic antibody-positive vasculitis, presenting as pulmonary or renal vasculitis and gangrene [119][120][121]. Toxic epidermal necrolysis has been reported, with recurrence following the reintroduction of hydralazine [122].…”

Section: Miscellaneous Agentsmentioning

confidence: 99%

Tolerability of Antihypertensive Medications in Older Adults

Dharmarajan

2015

Drugs Aging

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Several guidelines for hypertension have recently undergone revisions to incorporate an approach providing choices of medications based on age, race, and specific situations where hypertension may co-exist with disorders such as diabetes, coronary artery disease, heart failure and chronic kidney disease. Initial recommendations include diuretics, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and calcium channel blockers; beta blockers are favored in some guidelines and are a choice in specific settings. Within the classes of drugs, several antihypertensive agents provide options. This review discusses antihypertensive drugs by class, including adverse effects and tolerability, with preferences in older adults and specific settings. Adverse drug events from antihypertensive medications are discussed by class and where applicable for specific agents. Data from select studies pertinent to tolerability and adverse effects are presented in tables for several classes of drugs. The rationale for nonadherence to medication is reviewed, including the roles played by tolerability and adverse drug effects. Antihypertensive therapy in typical settings in older adults is discussed; they include hypertension in association with impaired cognition, depression, diabetes, sexual dysfunction, and falls. The key to successful therapy and tolerability is to promote a healthy lifestyle in conjunction with medications as the approach, thereby also lowering the adverse drug effects. The eventual choice of the specific drug(s) is based on risks, benefits, and patient preferences, and is best tailored for each older adult.

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“…In contrast to hydralazine-induced lupus, hydralazine-induced vasculitis can be severe with frequent involvement of the kidneys. Hydralazine-induced vasculitis involving the skin was first reported in 1980, and vasculitis involving the kidneys was first suspected in 1981 (5,6). Cases of rapidly progressive glomerulonephritis were reported in 1983, and subsequently, ANCA positivity was demonstrated in some of these cases (7,8).…”

Section: Introductionmentioning

confidence: 99%