Acute Facial Edema in a Patient with Systemic Lupus Erythematosus

Allergies have been found to be associated with systemic lupus erythematosus (SLE). However, few reports have described angioedema occurring in elderly men with systemic lupus erythematosus. Herein, we report the case of an 85-year-old man who presented with angioedema with eosinophilia. The patient was initially thought to have a drug-induced allergy. The differentiation between allergic reactions caused by drugs and those caused by eosinophilia with SLE can be challenging. The effect of the withdrawal of the suspected culprit drug and allergic dermal findings can be key to differentiating the two conditions. SLE is prevalent among younger generations; hence, active immunity can induce various symptoms, including eosinophilia, which causes angioedema. Even older people with SLE can have a strong immune reaction, resulting in angioedema with eosinophilia. In cases of localized facial edema in elderly patients with SLE, it is critical to consider angioedema caused by eosinophilia as a differential diagnosis.

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Patient on allergen immunotherapy developed systemic lupus erythematosus?– A clinico-pharmacological look out

IP International Journal of Orthopaedic Rheumatology ◽

10.18231/j.ijor.2021.020 ◽

2022 ◽

Vol 7 (2) ◽

pp. 90-92

Author(s):

Shatavisa Mukherjee ◽

Shambo S Samajdar ◽

Kaushik Basu ◽

Saibal Moitra ◽

Santanu K Tripath

Keyword(s):

Systemic Lupus Erythematosus ◽

Lupus Erythematosus ◽

Drug Exposure ◽

Allergen Immunotherapy ◽

Systemic Lupus ◽

Drug Induced ◽

Pharmacological Evaluation ◽

Culprit Drug ◽

Autoimmune Condition ◽

Insight Into

Drug induced lupus is an autoimmune condition secondary to drug exposure which leads to development of systemic lupus erythematosus (SLE). However, labelling the culprit drug needs a prudent insight into the pharmacological plausibility of each of the offending drugs in suspicion. Here we present a report where allergen immunotherapy was suspected to cause SLE and a deeper clinico-pharmacological evaluation cleared the air.

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Acute interstitial nephritis and drug-induced systemic lupus erythematosus due to chlorthalidone and amiodarone: A case report

SAGE Open Medical Case Reports ◽

10.1177/2050313x20910029 ◽

2020 ◽

Vol 8 ◽

pp. 2050313X2091002 ◽

Cited By ~ 1

Author(s):

Umut Selamet ◽

Ramy M Hanna ◽

Anthony Sisk ◽

Lama Abdelnour ◽

Lena Ghobry ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Interstitial Nephritis ◽

Lupus Erythematosus ◽

Kidney Biopsy ◽

Kidney Injury ◽

Acute Interstitial Nephritis ◽

Systemic Lupus ◽

Drug Induced ◽

Systemic Manifestations

Drug-induced lupus erythematosus has features distinct from primary systemic lupus erythematosus. It can occur with a wide variety of agents that result in the generation of anti-histone or other types of antibodies. Systemic manifestations of drug-induced systemic lupus erythematosus may include renal dysfunction due to circulating immune complexes or due to other immune reactions to the culprit medication(s). Acute interstitial nephritis occurs due to DNA–drug or protein–drug complexes that trigger an allergic immune response. We report a patient who developed acute kidney injury, rash, and drug-induced systemic lupus diagnosed by serologies after starting chlorthalidone and amiodarone. A renal biopsy showed acute interstitial nephritis and not lupus-induced glomerulonephritis. It is important to note that systemic lupus erythematosus and acute interstitial nephritis can occur together, and this report highlights the role of the kidney biopsy in ascertaining the pathological diagnosis and outlining therapy in drug-induced lupus erythematosus.

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Drug-induced subacute cutaneous lupus erythematosus in previously diagnosed systemic lupus erythematosus patients - a case series

JAAD Case Reports ◽

10.1016/j.jdcr.2021.03.048 ◽

2021 ◽

Author(s):

Emily Keyes ◽

Madison Grinnell ◽

Thomas Vazquez ◽

DeAnna Diaz ◽

Preethi Thomas ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Lupus Erythematosus ◽

Cutaneous Lupus Erythematosus ◽

Case Series ◽

Subacute Cutaneous Lupus Erythematosus ◽

Systemic Lupus ◽

Drug Induced ◽

Cutaneous Lupus

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Drug-induced systemic lupus erythematosus in ankylosing spondylitis associated with infliximab

Rheumatology ◽

10.1093/rheumatology/kei220 ◽

2005 ◽

Vol 45 (1) ◽

pp. 114-116 ◽

Cited By ~ 14

Author(s):

C. Pérez-García ◽

J. Maymo ◽

M. P. Lisbona Pérez ◽

M. Almirall Bernabé ◽

J. Carbonell Abelló

Keyword(s):

Systemic Lupus Erythematosus ◽

Ankylosing Spondylitis ◽

Lupus Erythematosus ◽

Systemic Lupus ◽

Drug Induced

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CARBAMAZEPINE INDUCED SLE-A RARE AND SERIOUS ADR

International Journal of Pharmacy and Pharmaceutical Sciences ◽

10.22159/ijpps.2017v9i1.14630 ◽

2016 ◽

Vol 9 (1) ◽

pp. 319

Author(s):

Sai Keerthana P. C. ◽

Anila K. N.

Keyword(s):

Systemic Lupus Erythematosus ◽

Autoimmune Disease ◽

Lupus Erythematosus ◽

Low Risk ◽

Probability Scale ◽

Systemic Lupus ◽

Drug Induced ◽

Rare Phenomenon ◽

Causality Score

<p style="line-height: 150%; margin-bottom: 0cm;" align="justify">Carbamazepine is a commonly used antiseizure medication. Carbamazepine-induced SLE (Systemic Lupus Erythematosus) is a very rare phenomenon. Drug-induced SLE is an autoimmune disease caused by long-term use of certain drugs. Carbamazepine is a drug with low risk for causing lupus symptoms. The process that leads to drug-induced SLE are not entirely understood. A very few cases are reported with carbamazepine association with SLE. Herein we report a case of 4 y old girl with SLE induced by carbamazepine showing a causality score of 8 by Naranjo ADR probability scale.</p>

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Drug-Induced Gingival Overgrowth in an 8-Year-Old Girl: A Case Report

Avicenna Journal of Dental Research ◽

10.34172/ajdr.2021.21 ◽

2021 ◽

Vol 13 (3) ◽

pp. 109-112

Author(s):

Parviz Torkzaban ◽

Amir Talaie

Keyword(s):

Systemic Lupus Erythematosus ◽

Case Report ◽

Autoimmune Disease ◽

Lupus Erythematosus ◽

Immunological Tolerance ◽

Systemic Autoimmune Disease ◽

Channel Blockers ◽

Systemic Lupus ◽

Drug Induced ◽

Gingival Overgrowth

Systemic lupus erythematosus is a systemic autoimmune disease that involves multi organs. Genetic, endocrine, immunological, and environmental factors influence the loss of immunological tolerance against self-antigens leading to the formation of pathogenic autoantibodies that cause tissue damage through multiple mechanisms. The gingival overgrowth can be caused by three factors: noninflammatory, hyperplastic reaction to the medication; chronic inflammatory hyperplasia; or a combined enlargement due to chronic inflammation and drug-induced hyperplasia. Drug-Induced Gingival Overgrowth is associated with the use of three major classes of drugs, namely anticonvulsants, calcium channel blockers, and immunosuppressants. Due to recent indications for these drugs, their use continues to grow.

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Severe hydralazine-induced lupus presenting as systemic lupus erythematosus

Lupus ◽

10.1177/0961203320906265 ◽

2020 ◽

Vol 29 (5) ◽

pp. 509-513 ◽

Cited By ~ 1

Author(s):

R L Rubin ◽

R F Haluptzok ◽

L M Davila

Keyword(s):

Systemic Lupus Erythematosus ◽

Lupus Erythematosus ◽

Systemic Autoimmune Disease ◽

Systemic Lupus ◽

Drug Usage ◽

Drug Induced ◽

Disease Etiology ◽

History Of ◽

Anti Inflammatory ◽

Symptoms And Signs

Despite its long history of untoward side effects of a systemic autoimmune disease, drug-induced lupus can be difficult to recognize because of the disconnect between chronic drug usage and onset of symptoms. In this case, the patient was treated with hydralazine for two years when symptoms were initially reported, but a diagnosis of hydralazine-induced lupus was not considered for another half year. Despite treatment with steroidal and nonsteroidal anti-inflammatory medications during this period, rheumatologic symptoms and signs continued to deteriorate, consistent with the diagnosis of systemic lupus erythematosus. Not until the patient voluntarily discontinued hydralazine did symptoms begin to improve, fully resolving over the subsequent 6–12 months largely in the absence of anti-inflammatory medication. This patient demonstrates that failure to recognize a drug-induced disease etiology can result in substantial worsening of rheumatologic symptoms over the subsequent six months, ultimately satisfying criteria for systemic lupus erythematosus. While symptoms and signs largely normalized, some laboratory abnormalities and occasional arthralgia remained two years after discontinuing hydralazine, suggesting smoldering inflammatory disease.

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Drug-induced systemic lupus: revisiting the ever-changing spectrum of the disease using the WHO pharmacovigilance database

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2018-214598 ◽

2019 ◽

Vol 78 (4) ◽

pp. 504-508 ◽

Cited By ~ 21

Author(s):

Laurent Arnaud ◽

Philippe Mertz ◽

Pierre-Edouard Gavand ◽

Thierry Martin ◽

François Chasset ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Lupus Erythematosus ◽

Individual Case ◽

Systemic Lupus ◽

Drug Induced ◽

Serious Adverse Event ◽

Registration Number ◽

Pharmacovigilance Database ◽

Male Sex ◽

Medical Dictionary

ObjectiveDrug-induced lupus (DIL) is an idiosyncratic side effect of treatments in which symptoms overlap with those of systemic lupus erythematosus (SLE). The spectrum of DIL constantly evolves with that of the pharmacopoeia. Here, we used VigiBase, the WHO global individual case safety reports (ICSRs) database, to identify the main drugs associated with DIL.MethodsWe analysed all ICSRs classified as ‘systemic lupus erythematosus’ according to the Medical Dictionary for Drug Regulatory Activities term (preferred term level) in VigiBase. The drugs considered in the analysis were those not used to treat SLE, with a positive lower end of the 95% credibility interval for the information component (IC025) ≥0, an indicator value for disproportionate Bayesian reporting.ResultsA total of 12 166 DIL ICSRs were identified using VigiBase. From those, 8163 ICSRs reporting on 118 suspected drugs with IC025 ≥0 were extracted. The median age at DIL onset was 49 years and the female to male sex ratio was 4.3. The median delay between start of suspected treatment and DIL occurrence was 172 days. DIL was reported as serious adverse event in 55.4%. Among the 118 suspected drugs, 42 had not been previously reported in association with DIL. The drugs associated with the highest number of DIL cases were infliximab, adalimumab, etanercept, procainamide and hydralazine.ConclusionThis study enables the identification of 118 drugs associated with DIL. The list of suspected drugs may prove useful to physicians when confronted with potential DIL cases.Trial registration numberNCT03480529.

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