A case of possible phenytoin-induced systemic lupus erythematosus is presented in a patient with a twenty-year history of epilepsy. The failure of seizure control in the presence of adequate anticonvulsant blood levels pointed to an underlying disease state. Drug-induced and idiopathic systemic lupus erythematosus are quite similar in clinical and laboratory manifestations. However, antibodies to native (double-stranded)-DNA seem to be consistent with the idiopathic form. A review of drug-induced systemic lupus erythematosus is presented.
Get full access to this article
View all access options for this article.
References
1.
Harrison's Principles of Internal Medicine, 7th Ed., p. 385–389, McGraw-Hill, Inc., New York, 1974.
2.
LeeS. L.ChaseP. H.: Drug-Induced Systemic Lupus Erythematosus: A Critical Review, Sem. Arthritis Rheum.5: 83–103 (Aug.) 1975.
ElsasL. J.HayslettJ. P.SpargoB. H.DurantJ. L.RosenbergL. E.: Wilson's Disease with Reversible Renal Tubular Dysfunction, Ann. Intern. Med.75: 427–433 (Sept.) 1971.
5.
HolleyH. L.: Evidence for a Predisposition to Rheumatic Diseases in Families of Patients Developing Drug-Induced Systemic Lupus Erythematosus, Arthritis Rheum.7: 684–686 (Dec.) 1964.
6.
Alarcon-SegoviaD.FishbeinE.ReyesP. A.DiesH.ShwadskyS.: Antinuclear Antibodies in Patients on Anticonvulsant Therapy, Clin. Exp. Immunol.12: 39–44, 1972.
7.
HarpeyJ-P.: Lupus-like Syndromes Induced by Drugs, Ann. Allergy33: 256–261 (Nov.) 1974.
8.
Primer on the Rheumatic Diseases, J. Am. Med. Assoc.224 (S):39–49 (Apr. 30) 1973.
9.
BlomgrenS. E.: Drug-induced Lupus Erythematosus, Sem. Hematol.10: 345–349 (Oct.) 1973.
10.
HahnB. H.SharpG. C.IrvinW. C.KantorO. S.GardnerC. A.BagbyM. K.PerryH. M.OsterlandC. K.: Immune Response to Hydralazine and Nuclear Antigens in Hydralazine-Induced Lupus Erythematosus. Ann. Intern. Med.76: 365–374 (Mar.) 1972.
GrillW. F.: Carbamazepine, Ann. Intern. Med.79: 844–847 (Dec.) 1973.
13.
ChristiansenJ.DamM.: Influence of Phenobarbital and Phenytoin on Plasma Carbamazepine Levels in Patients with Epilepsy, Acta. Neurol. Scand.49: 543–546, 1973.
14.
The Pharmacological Basis of Therapeutics, 5th Ed., GoodmanGilman (Eds.), p. 17 & 110. Macmillan Publishing Co., Inc., New York, 1975.
15.
BrooksS. M.WerkE. E.AckermonS. J.SullivanI.ThrasherK.: Adverse Effects of Phenobarbital on Corticosteroid Metabolism in Patients with Bronchial Asthma, N. Engl. J. Med.286: 1125–1128 (May 25) 1972.
16.
BrownS. R.HartshornE. A.: Interaction of CNS Drugs — Hypnotics and Sedatives, Drug Intell. Clin. Pharm.10: 570–586 (Oct.) 1976.
