In 1999, the american college of rheumatology developed 19 discrete neuropsychiatric syndromes that comprised npsle. Druginduced lupus erythematosus uf health, university of. Dile abbreviation stands for drug induced lupus erythematosus. Lupus erythematosus is a collection of autoimmune diseases in which the human immune system becomes hyperactive and attacks healthy. Some lids induce a condition more akin to subacute cutaneous lupus erythematosus scle consequently, unless stated otherwise, reference to dil in this chapter means the term to encompass druginduced sle, scle and ccle chronic cutaneous lupus erythematosus. Capecitabine is an orally administered tumorselective fluoropyrimidine that acts as a prodrug of 5fluorouracil and bevacizumab is an antivascular endothelial growth factor antivegf antibody, both are used for the treatment of patients with colorectal cancer.
Reactive hypoglycemia and insulin autoantibodies in drug. The terms drug induced lupus dil and druginduced lupus erythematosus dile are preferred, but other ones are also used drug related lupus, lupus like syndrome, and lupus erythematosus. Related conditions are drug induced cutaneous lupus and drug induced anca vasculitis. Symptoms usually occur 3 to 6 months after starting a medication, and disappear once the medicine is stopped. Inherited differences in drug metabolism eg, acetylator status and immunogenetic characteristics are genetic factors that may influence the risk of developing disease. Rheumatic diseases induced by drugs and environmental factors. A few years ago, i began having lupus like symptoms that caused a lot of dysfunction in my life for over a year, and i had a positive ana test. The use of the abbreviation sle means idiopathic sle throughout this chapter. The mechanism or mechanisms involved in druginduced lupus remain uncertain. Specific criteria for diagnosing drug induced lupus have not been formally established. No specific criteria have been established yet to arrive at a diagnosis of drug induced lupus. Oral ulcers, hair loss, photosensitivity and central nervous system symptoms are also very rare in drug induced lupus. Early reports suggested that procainamide and hydralazine were associated with the highest risk of developing lupus, quinidine with a moderate risk and all other drugs were considered low or very low risk.
Drugs less frequently associated with the disease are chlorpromazine, isoniazid, methyldopa, penicillamine, quinidine and sulfasalazine. Druginduced lupus definition of druginduced lupus by. Clinical features of patients with drug induced, rossapositive cutaneous lupus erythematosus cle. The terms drug induced lupus dil and drug induced lupus erythematosus dile are preferred, but other ones are also used drug related lupus, lupus like syndrome, and lupus erythematosus. This means your body attacks healthy tissue by mistake. Druginduced lupus erythematosus actas dermosifiliograficas.
However, symptoms often overlap with those of systemic lupus erythematosus sle. Drug induced lupus has anyone ever been diagnosed with dil drug induced lupus. Subacute cutaneous lupus erythematosus scle is a distinct subset of cutaneous lupus erythematosus and presents clinically with nonscarring, erythematous, annular polycyclic or papulosquamous cutaneous eruptions in sunexposed areas. Drug induced lupus is also called drug induced lupus erythematosus dile. While scle can be idiopathic or drug induced, they are generally immunologically, histopathologically, and. Drug induced lupus erythematosus is a generally reversible condition that usually occurs in people being treated for a longterm illness. Characteristics of druginduced lupus erythematosus. Drug induced lupus erythematosus dil or dile is an autoimmune disorder similar to systemic lupus erythematosus sle caused by chronic use of certain drugs. However, various theories have been developed regarding the pathogenesis of druginduced lupus. Lupus is a condition that can happen when your bodys immune system attacks your healthy tissues and organs. Drug induced lupus erythematosus has previously been reported to be associated with wilson disease as a complication of treatment with dpenicillamine. These drugs cause an autoimmune response the body attacks its own cells producing symptoms similar to those of sle.
Caucasians are six times more likely to develop dile compared to other ethnicities. While drug induced lupus may cause rash, arthritis and fever that appear similar to the systemic form of. Lupus is usually influenced by gene polymorphismseritematozjs of which have now been linked with the disorder. How is druginduced lupus erythematosus differentiated from. Symptoms of these diseases can affect many different body systems, including joints, skin, kidneys, blood cells, heart, and lungs. Dile shows less predilections for women and africans, and generally affects older patients than idiopathic sle. Drug induced lupus erythematosus tends to affect individuals between the ages of 5070 years old. The most common individual agents are procainamide and hydralazine. Druginduced subacute cutaneous lupus erythematosus. In lupus, the bodys immune system, which normally functions to protect against foreign invaders, becomes. Drug induced lupus dil refers to an idiosyncratic side effect of numerous, apparently unrelated, medications, in which symptoms overlap with those of systemic lupus erythematosus. Feb, 2020 some people develop a form of lupus that involves only the skin, called cutaneous lupus or discoid lupus erythematosus.
Neuropsychiatric systemic lupus erythematosus npsle is a complex neurological disorder characterized by neuropsychological dysfunction. However, symptoms of drug induced lupus generally disappear once the medication that triggered the episode is stopped. Druginduced lupus erythematosus dile is a variant of lupus erythematosus that resolves within days to months after withdrawal of the culprit drug in. Although the pathogenesis of dil is not well understood, a genetic predisposition may play a role in the case of certain drugs, particularly those agents that are metabolised by acetylation such as procainamide and hydralazine, with disease more likely to. T he most frequently evoked theory to explain the pathogenesis of druginduced systemic lupus er ythematosus. Druginduced lupus is when its caused by taking certain prescription medicines for. The terms druginduced lupus dil and druginduced lupus erythematosus dile are preferred, but other ones are also useddrugrelated lupus, lupuslike syndrome, and lupus erythematosus. Drug induced lupus erythematosus is similar but not identical to systemic lupus erythematosus sle. Drug induced lupus erythematosus is an autoimmune disorder similar to systemic lupus erythematosus sle caused by chronic use of certain drugs. Although the term is frequently used alone to designate lupus vulgaris and sometimes lupus erythematosus, without a modifier it has no meaning.
A, the index patient shows scaly, annular, subacute cletype lesions on the lateral aspect of the right arm. Drug induced lupus erythematosus dile is a lupus like syndrome temporally related to continuous drug exposure from one month to as long as over a decade which resolves after discontinuation of the drug. Dile or dil can occur as a sideeffect of certain medications. The utility of antihistone antibody screening in the. Drug induced lupus is similar to sle, but occurs as the result of an overreaction to certain medications.
How is druginduced lupus erythematosus differentiated. The mechanism or mechanisms involved in drug induced lupus remain uncertain. However, the autoantibody pattern differs from those of most other forms of drug induced lupus. Drug induced lupus dil is a disorder with clinical, histological, and immunological features similar to idiopathic systemic lupus erythematosus, but that occurs when certain drugs are taken and resolves after discontinuation of the offending agent. Druginduced lupus erythematosus information mount sinai. Druginduced lupus dil is an autoimmune phenomenon where a drug exposure leads to the development of systemic lupus erythematosus. Jul 10, 2018 drug induced lupus erythematosus dile is a variant of lupus erythematosus that resolves within days to months after withdrawal of the culprit drug in a patient with no underlying immune system dysfunction. The objective of this study is to summarize current knowledge on rheumatic diseases induced by drugs and environmental factors.
Drug induced lupus and sle sle is distinct from drug induced lupus, since dil generally has milder symptoms than sle, and no skin or kidney disease. Drug induced lupus erythematosus is an autoimmune disorder that is triggered by a reaction to a medicine. Jul 18, 2016 the most frequently mentioned rheumatic diseases caused by drugs and environmental factors include systemic lupus erythematosus, scleroderma, systemic vasculitis, polymyositis, dermatomyositis, and sjogrens syndrome. Druginduced lupus erythematosus is a result of sideeffects, which occur due to prolonged usage of certain medications. Druginduced lupus erythematosus statpearls ncbi bookshelf. Apr 20, 2020 many pharmacologic agents have been associated with a lupuslike syndrome see see drug induced lupus erythematosus, but procainamide, hydralazine, and isoniazid have been studied the most. Systemic lupus erythematosus sle is an autoimmune disease of unknown origin, but many drugs have been seen to induce lupuslike signs and symptoms. Unlike sle, drug induced lupus erythematosus does not have a gender preference. Druginduced lupus erythematosus dile is a disorder that exhibits symptoms similar to that of lupus.
An 82yearold woman developed symptomatic reactive hypoglycemia in the same year she developed a lupuslike syndrome, probably secondary to. Drug induced lupus erythematosus due to capecitabine and. Drug induced lupus erythematosus dile is a syndrome that is formed by lupus like symptoms and laboratory characteristics. Although the pathogenesis of dil is not well understood, a genetic predisposition may play a role in the case of certain drugs, particularly those. Druginduced lupus erythematosus is an autoimmune disorder similar to systemic lupus erythematosus sle caused by chronic use of certain drugs. What is the abbreviation for drug induced lupus erythematosus. Drug induced lupus erythematosus dile is a variant of lupus erythematosus that resolves within days to months after withdrawal of the culprit drug in a patient with no underlying immune system dysfunction. Another form of lupus follows exposure to certain drugs drug induced lupus including procainamide and hydralazine.
Druginduced, rossapositive cutaneous lupus erythematosus. Care must be taken to correctly diagnose the symptoms of dile and differentiate it from systemic lupus erythematosus sle, and dile should be. Druginduced lupus erythematosus dilesymptomstreatment. However, various theories have been developed regarding the pathogenesis of drug induced lupus. Many pharmacologic agents have been associated with a lupuslike syndrome see see druginduced lupus erythematosus, but procainamide, hydralazine. Oct 26, 2012 drug induced lupus is a syndrome resembling mild systemic lupus erythematosus which can complicate treatment with certain apparently unrelated therapies. Lupus erythematosus is a collection of autoimmune diseases in which the human immune system becomes hyperactive and attacks healthy tissues. As in idiopathic or usualtype lupus erythematosus le, there are three categories recognised. Sle is associated with dysregulation of cellular im. Druginduced lupus erythematosus clinical presentation. Drug induced lupus erythematosus is an uncommon, mild to moderately severe, a lupus like syndrome related in time to continuous exposure to a specific medication and which resolves after the trigger drug is ceased.
What is the abbreviation for druginduced lupus erythematosus. Nov 20, 2012 the generation of autoantibodies and autoimmune diseases such as systemic lupus erythematosus has been associated with the use of certain drugs in humans. Druginduced lupus erythematosus with emphasis on skin. Dile abbreviation stands for druginduced lupus erythematosus. Druginduced lupus erythematosus thearchangelmichaels blog. Druginduced lupus dil refers to an idiosyncratic side effect of numerous, apparently unrelated, medications, in which symptoms overlap with those of systemic lupus erythematosus. Aug 16, 2018 drug induced lupus erythematosus dile is a disorder that exhibits symptoms similar to that of lupus. Mary anne dooley, in systemic lupus erythematosus, 2016.
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