Which drug may cause a systemic lupus erythematosus-like syndrome at high doses?

Which drug may cause a systemic lupus erythematosus-like syndrome at high doses?

• A. Captopril
• B. Hydralazine
• C. Minoxidil
• D. Labetalol

Answer: (B)

Drug-induced lupus erythematosus occurs when a medication triggers an autoimmune reaction that resembles systemic lupus but is reversible upon stopping the drug. Hydralazine is the classic culprit, especially at high doses or in people who metabolize drugs slowly (slow acetylators). The immune response often involves antihistone antibodies, and patients typically have a positive ANA with anti-histone antibodies, while anti-dsDNA is usually absent. Clinically, you see arthritis, fever, serositis, and malaise, and symptoms tend to improve after discontinuing the drug, though it may take weeks to months. The other drugs listed are not classically associated with drug-induced lupus in the way hydralazine is, though they carry other adverse effects and do not reliably produce a lupus-like syndrome even at high doses.

Drug-induced lupus erythematosus occurs when a medication triggers an autoimmune reaction that resembles systemic lupus but is reversible upon stopping the drug. Hydralazine is the classic culprit, especially at high doses or in people who metabolize drugs slowly (slow acetylators). The immune response often involves antihistone antibodies, and patients typically have a positive ANA with anti-histone antibodies, while anti-dsDNA is usually absent. Clinically, you see arthritis, fever, serositis, and malaise, and symptoms tend to improve after discontinuing the drug, though it may take weeks to months. The other drugs listed are not classically associated with drug-induced lupus in the way hydralazine is, though they carry other adverse effects and do not reliably produce a lupus-like syndrome even at high doses.