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Acute Low-Dose Hydralazine-Induced Lupus Pneumonitis
Joint Authors
Holman, Sarah K.
Parris, Donique
Meyers, Sarah
Ramirez, Jason
Source
Issue
Vol. 2017, Issue 2017 (31 Dec. 2017), pp.1-4, 4 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2017-08-08
Country of Publication
Egypt
No. of Pages
4
Main Subjects
Abstract EN
A 35-year-old female was started on hydralazine 10 mg orally three times a day for treatment of postpartum hypertension.
Three months later, after multiple unsuccessful courses of prednisone and antibiotics for presumed pneumonia and asthma exacerbations, her respiratory symptoms progressed in severity and she developed resting hypoxia.
Previous diagnostic work-up included spirometry with a restrictive pattern, chest CT showing bilateral basilar consolidation, negative BAL, and nonspecific findings on lung biopsy of mild inflammatory cells.
Review of systems was positive for arthralgia, lymphadenopathy, paresthesia, and fatigue that began four weeks after starting hydralazine.
A clinical diagnosis of hydralazine-induced lupus (HIL) with pneumonitis was made.
Antihistone antibodies were positive supporting a diagnosis of HIL.
Management included cessation of hydralazine and a prolonged steroid taper.
Within days, patient began improving symptomatically.
Six weeks later, CT chest showed complete resolution of infiltrates.
Genetic testing revealed she was heterozygous for N-acetyltransferase 2 (intermediate acetylator).
Drug-induced lupus should be considered in patients with lupus-like symptoms taking medications with a known association.
While the majority of HIL cases occur with high doses and prolonged treatment, cases of low-dose HIL have been reported in patients who are slow acetylators.
American Psychological Association (APA)
Holman, Sarah K.& Parris, Donique& Meyers, Sarah& Ramirez, Jason. 2017. Acute Low-Dose Hydralazine-Induced Lupus Pneumonitis. Case Reports in Pulmonology،Vol. 2017, no. 2017, pp.1-4.
https://search.emarefa.net/detail/BIM-1149689
Modern Language Association (MLA)
Holman, Sarah K.…[et al.]. Acute Low-Dose Hydralazine-Induced Lupus Pneumonitis. Case Reports in Pulmonology No. 2017 (2017), pp.1-4.
https://search.emarefa.net/detail/BIM-1149689
American Medical Association (AMA)
Holman, Sarah K.& Parris, Donique& Meyers, Sarah& Ramirez, Jason. Acute Low-Dose Hydralazine-Induced Lupus Pneumonitis. Case Reports in Pulmonology. 2017. Vol. 2017, no. 2017, pp.1-4.
https://search.emarefa.net/detail/BIM-1149689
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1149689