Drug-induced systemic lupus erythematosus: A comprehensive review

Drug-induced systemic lupus erythematosus (DILE) is a rare autoimmune disorder that mimics idiopathic systemic lupus erythematosus (SLE), but with a clear temporal relationship to the use of certain medications. This comprehensive review explores the mechanisms, diagnosis, and management of DILE. The condition is primarily immunologically mediated, with drugs triggering immune responses through processes such as antibody formation, T-cell activation, and oxidative stress. Genetic predispositions, including variations in drug-metabolizing enzymes, play a role in susceptibility. Drugs such as hydralazine, procainamide, and minocycline are commonly implicated in DILE, each triggering the formation of autoantibodies, particularly anti-histone antibodies. Diagnosis relies on clinical history, serological testing, and the identification of specific autoantibodies. DILE shares many clinical features with idiopathic lupus but is distinguishable by its typically milder course and absence of renal or neurological involvement. Management primarily involves discontinuing the offending drug, with symptomatic treatment using NSAIDs or corticosteroids. The prognosis is generally favorable, with most symptoms resolving after drug cessation and minimal long-term organ damage. Early recognition and intervention are essential to ensuring a positive outcome and preventing unnecessary treatments.