drug-induced lupus

薬剤性ループス

WordNet

1. reason or establish by induction
2. cause to arise; "induce a crisis" (同)bring_on
3. produce electric current by electrostatic or magnetic processes (同)induct
4. cause to do; cause to act in a specified manner; "The ads induced me to buy a VCR"; "My children finally got me to buy a computer"; "My wife made me buy a new sofa" (同)stimulate, cause, have, get, make
5. cause to occur rapidly; "the infection precipitated a high fever and allergic reactions" (同)stimulate, rush, hasten
6. use recreational drugs (同)do drugs
7. administer a drug to; "They drugged the kidnapped tourist" (同)dose
8. a substance that is used as a medicine or narcotic
9. brought about or caused; not spontaneous; "a case of steroid-induced weakness"
10. any of several forms of ulcerative skin disease
11. a constellation in the southern hemisphere near Centaurus

PrepTutorEJDIC

1. 〈人〉‘に'『勧めて』(…)『させる』 / …‘を'『引き起こす』,もたらす(cause) / 〈電気〉‘を'誘導する / …‘を'帰納する
2. 『薬』,薬品,薬剤 / 『麻薬』,麻酔剤 / 〈人〉‘に'薬(特に麻酔剤)を与える / 〈飲食物〉‘に'(麻酔薬・毒薬などの)薬を混ぜる
3. 狼瘡(ろうそう)(皮膚結核の一種)

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/09/18 04:32:40」(JST)

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Drug-induced lupus erythematosus
Classification and external resources
Hydralazine, a medication associated with drug-induced lupus erythematosus
ICD-10	M32.0
ICD-9	710.0
OMIM	152700
DiseasesDB	12782
MedlinePlus	000435
eMedicine	med/2228 emerg/564
MeSH	C17.300.480

Drug-induced lupus erythematosus (DIL or DILE) is an autoimmune disorder (similar to systemic lupus erythematosus [SLE]) caused by chronic use of certain drugs. These drugs cause an autoimmune response (the body attacks its own cells) producing symptoms similar to those of SLE. There are 38 known medications to cause DIL but there are three that report the highest number of cases: hydralazine, procainamide, and isoniazid. While the criteria for diagnosing DIL has not been thoroughly established, symptoms of DIL typically present as myalgia and arthralgia. Generally, the symptoms recede after discontinuing use of the drugs.

Causes

The processes that lead to drug-induced lupus erythematosus are not entirely understood. The exact processes that occur are not known even after 50 years since its discovery, but many studies present theories on the mechanisms of DIL.

A predisposing factor to developing DIL is N-acetylation speed, or the rate at which the body can metabolize the drug. This is greatly decreased in patients with a genetic deficiency of the enzyme N-acetyltransferase. A study showed that 29 of 30 patients with DIL were slow acetylators. In addition, these patients had more hydralazine metabolites in their urine than fast acetylators. These metabolites (byproducts of the interactions between the drug and constituents in the body) of hydralazine are said to have been created when white blood cells have been activated, meaning they are stimulated to produce a respiratory burst. Respiratory burst in white blood cells induces an increased production of free radicals and oxidants such as hydrogen peroxide. These oxidants have been found to react with hydralazine to produce a reactive species that is able to bond to protein. Monocytes, one type of leukocyte, detect the antigen and relay the recognition to T helper cells, creating antinuclear antibodies leading to an immune response. Further studies on the interactions between oxidants and hydralazine are necessary to understand the processes involved in DIL.

Of the drugs that cause DIL, hydralazine has been found to cause a higher incidence. Hydralazine is a medication used to treat high blood pressure. Approximately 5% of the patients who have taken hydralazine over long periods of time and in high doses have shown DIL-like symptoms. Many of the other drugs have a low to very low risk to develop DIL. The following table shows the risk of development of DIL of some of these drugs on a very to high scale.

• High risk:
  • Procainamide (antiarrhythmic)
  • Hydralazine (antihypertensive)

• Moderate to low risk:
  • Infliximab anti (TNF-α)
  • Etanercept anti (TNF-α)
  • Isoniazid (antibiotic)
  • Minocycline (antibiotic)
  • Pyrazinamide (antibiotic)
  • Quinidine (antiarrhythmic)
  • D-Penicillamine (anti-inflammatory)
  • Carbamazepine (anticonvulsant)
  • Oxcarbazepine (anticonvulsant)
  • Phenytoin (anticonvulsant)
  • Propafenone (antiarrhythmic)

Signs and symptoms

Signs and symptoms of drug-induced lupus erythematosus include the following:

• Joint pain (Arthralgia) and muscle pain (myalgia)
• Fatigue
• Inflammation of the sac around the heart (pericarditis) and the sac around the lungs (pleuritis)
• Anti-histone antibodies in 95% of cases

These signs and symptoms are not side effects of the drugs taken which occur during short term use. DIL occurs over long-term and chronic use of the medications listed above. While these symptoms are similar to those of systemic lupus erythematosus, they are generally not as severe unless they are ignored which leads to more harsh symptoms, and in some reported cases, death.

Treatment

It is important to recognize early that these drugs are causing DIL like symptoms and discontinue use of the drug. Symptoms of drug-induced lupus erythematosus generally disappear days to weeks after medication use is discontinued. Non-steroidal anti-inflammatory drugs (NSAIDs) will quicken the healing process. Corticosteroids may be used if more severe symptoms of DIL are present.

See also

• Anti-histone antibody
• Lupus erythematosus
• Hydralazine
• Discoid lupus erythematosus
• List of cutaneous conditions

References

External links

• S.L.E. Lupus Foundation
• Lupus Foundation of America, Inc.
• Lupus Research Institute
• eMedicine

UpToDate Contents

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• 1. 薬物誘発性ループス drug induced lupus
• 2. 頭部白癬 tinea capitis
• 3. 腫瘍壊死因子α（TNF-α）阻害剤：抗体、自己抗体、および自己免疫疾患の誘導 tumor necrosis factor alpha inhibitors induction of antibodies autoantibodies and autoimmune diseases
• 4. 心血管系剤によって誘発された肺疾患 pulmonary disease induced by cardiovascular drugs
• 5. 全身性エリテマトーデスにおける腎疾患の診断および分類 diagnosis and classification of renal disease in systemic lupus erythematosus

English Journal

• Toll-like receptor 9 SNPs are susceptible to the development and progression of membranous glomerulonephritis: 27 years follow-up in Taiwan.

• Chen YT, Wei CC, Ng KL, Chen CH, Chan CJ, Chen XX, Chang YY, Chen SY, Tsai FJ.SourceDepartment of Medical Research, Genetics Center, China Medical University Hospital , Taichung , Taiwan .
• Renal failure.Ren Fail.2013 Aug 21. [Epub ahead of print]
• Abstract The purpose of this study was to determine whether toll-like receptors 9 (TLR9) gene polymorphisms (rs352139 and rs352140) were markers of susceptibility to the development and progression of membranous nephropathy (MGN) in Taiwanese patients. The polymorphisms were investigated by polymera
• PMID 23964786

• A case of infliximab-induced lupus in a patient with ankylosing spondylitis: is it safe switch to another anti-TNF-α agent?

• Santiago T, Santiago MG, Rovisco J, Duarte C, Malcata A, da Silva JA.SourceClínica Universitária de Reumatologia (CURe), Hospitais da Universidade de Coimbra, Praceta Mota Pinto, 3000-075, Coimbra, Portugal, tlousasantiago@hotmail.com.
• Clinical rheumatology.Clin Rheumatol.2013 Aug 17. [Epub ahead of print]
• Anti-TNF-α therapies are the latest class of medications found to be associated with drug-induced lupus, a distinctive entity known as anti-TNF-α-induced lupus (ATIL) (Williams et al., Rheumatology (Oxford) 48:716-20, 2009; De Rycke et al., Lupus 14:931-7, 2005; De Bandt et al., Clin Rheumatol 22:
• PMID 23955767

• [Renal diseases in rheumatology].

• Janneck M, Velden J, Iking-Konert C.SourceZentrum für Innere Medizin, III. Medizinische Klinik und Poliklinik, Klinik für Nephrologie und Rheumatologie, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland.
• Zeitschrift für Rheumatologie.Z Rheumatol.2013 Aug;72(6):555-70. doi: 10.1007/s00393-013-1182-1.
• Renal involvement and renal function disorders are commonplace in patients with rheumatic diseases and are often decisive for the prognosis. Typical nephrological complications in rheumatology are renal manifestations or delayed sequelae of the underlying disease in addition to drug-induced renal fa
• PMID 23921983

Japanese Journal

• Beneficial Therapeutic Effect of Plasma Exchange Followed by Prednisolone for Drug-Induced Hypersensitivity Syndrome Caused by Allopurinol

• Iijima Shigeruko,Ebihara Itaru,Yamada Hiromichi
• 日本アフェレシス学会雑誌 31(3), 237-241, 2012-10-31
• … The efficacy of plasma exchange for the treatment of severe drug eruption, such as toxic epidermal necrolysis or Stevens-Johnson syndrome, has been well established in many recent reports; … however, that for drug-induced hypersensitivity syndrome (DIHS) has not yet to be clarified. … We here report an 84-year-old woman with allopurinol-induced DIHS, who had taken a small dose of prednisolone for a long period for systemic lupus erythematosus. …
• NAID 110009543814

• infliximab 投与により薬剤誘発性ループスを発症した潰瘍性大腸炎の1例

• 西川 潤,宮嵜 孝子,鈴木 庸弘,板谷 優子,山脇 秀元,三原 弘,蓮本 祐史,藤浪 斗,小川 浩平,細川 歩,工藤 俊彦,杉山 敏郎
• 日本消化器病學會雜誌 = The Japanese journal of gastro-enterology 108(9), 1535-1539, 2011-09-05
• infliximab投与により薬剤誘発性ループスを発症した潰瘍性大腸炎の1例を経験した．ステロイド依存性潰瘍性大腸炎患者に対し，寛解導入ならびに寛解維持目的でinfliximab投与を施行した．第5回目のinfliximab投与後に多関節痛，リンパ球減少，抗二本鎖DNA抗体陽性，抗核抗体陽性を呈し薬剤誘発性ループスと診断した．保存的治療とinfliximab投与中止により症状の改善が得られた．
• NAID 10030298345

• Etanercept-Induced Lupus Accompanied by Hemophagocytic Syndrome

• Araki Daisuke,Fujii Hiroshi,Matsumura Masami,Yamagishi Masakazu,Yachie Akihiro,Kawano Mitsuhiro
• Internal Medicine 50(17), 1843-1848, 2011
• … Hemophagocytic syndrome (HPS) is a severe, potentially life-threatening disorder characterized by an excessive activation of macrophages, such as may occur in the setting of lupus. … Simultaneously, lupus-like features including pleuritis, hypocomplementemia, and positive autoantibodies were observed. … She was diagnosed with HPS related to etanercept-induced lupus, and underwent immunosuppressive therapy with successful recovery. …
• NAID 130002063083

Related Links

• Drug-induced lupus - Evidence-Based Clinical Decision ...

Olsen NJ. Drug-induced autoimmunity. Best Pract Res Clin Rheumatol 2004; 18:677. Borchers AT, Keen CL, Gershwin ME. Drug-induced lupus. Ann N Y Acad Sci 2007; 1108:166. Vasoo S. Drug-induced lupus: an update. Lupus ...

• Drug-induced lupus erythematosus: MedlinePlus Medical ...

Drug-induced lupus erythematosus is similar to systemic lupus erythematosus (SLE). It is an autoimmune disorder. This means your body attacks healthy tissue by mistake. It is caused by an overreaction to a medicine.

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★リンクテーブル★

リンク元	「薬剤性ループス」
拡張検索	「drug-induced lupus syndrome」
関連記事	「induce」「induced」「lupus」「drug」

「薬剤性ループス」

　　[★]

同

薬剤性ループス様症候群 drug-induced lupus syndrome、薬剤誘発性ループス drug-induced lupus、薬剤関連ループス, 全身性エリテマトーデス型薬疹 drug-induced systemic lupus erythematosus、LE様薬疹

• 薬剤(ex.ヒダントイン、プロカインアミド)の長期服用により出現する全身性エリテマトーデス様の病態。(SLE症状、抗核抗体(抗ヒストン抗体))
• 投薬により臨床症状、抗核抗体が消失。

「drug-induced lupus syndrome」

　　[★] 薬剤性ループス様症候群

「induce」

　　[★]

• v.

• 誘発する、誘導する、誘起する、導入する、引き起こす

関

cause、challenge、derivation、elicit、elicitation、evocation、evoke、guidance、induction、inductive、introduce、introduction、precipitate、provocation、provoke、spark

　 　 　 　 　 　

「induced」

　　[★]

• v.

• (induceの過去分詞)誘導される、引き起こされる

hypercalcaemia induced pancreatitis 高カルシウム血症による膵炎

　

「lupus」

　　[★] ループス、狼瘡

　 　

「drug」

　　[★]

同

drugs