Which drug is classically associated with drug-induced lupus?

Which drug is classically associated with drug-induced lupus?

• A. Aspirin
• B. Metformin
• C. Lisinopril
• D. Hydralazine

Answer: (D)

Drug-induced lupus arises when a medication triggers an autoimmune reaction that mimics lupus but is reversible after stopping the drug. Hydralazine is classically linked to this condition. It’s a vasodilator used for hypertension, and with longer use or higher doses—especially in people with slow acetylator liver enzymes—it can prompt the immune system to produce autoantibodies against histones. This leads to lupus-like symptoms such as arthritis and serositis, and often a positive ANA with anti-histone antibodies. Importantly, anti-dsDNA and anti-Smith antibodies are usually absent, which helps distinguish this from idiopathic SLE. When the drug is discontinued, the symptoms and antibody abnormalities typically improve or resolve. The other drugs listed are not the classic culprits for drug-induced lupus.

Drug-induced lupus arises when a medication triggers an autoimmune reaction that mimics lupus but is reversible after stopping the drug. Hydralazine is classically linked to this condition. It’s a vasodilator used for hypertension, and with longer use or higher doses—especially in people with slow acetylator liver enzymes—it can prompt the immune system to produce autoantibodies against histones. This leads to lupus-like symptoms such as arthritis and serositis, and often a positive ANA with anti-histone antibodies. Importantly, anti-dsDNA and anti-Smith antibodies are usually absent, which helps distinguish this from idiopathic SLE. When the drug is discontinued, the symptoms and antibody abnormalities typically improve or resolve.

The other drugs listed are not the classic culprits for drug-induced lupus.