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. 2018 Dec;5(4):272-274.
doi: 10.5152/eurjrheum.2018.18040. Epub 2018 Jun 20.

Antinuclear antibody-negative lupus? An ominous presentation of hydralazine-induced lupus syndrome

Theodros Solomon-Tsegaye  1 , Edward L Treadwell  2 , Reginald Obi  3 , Mariavittoria Pitzalis  4
Affiliations

Antinuclear antibody-negative lupus? An ominous presentation of hydralazine-induced lupus syndrome

Theodros Solomon-Tsegaye et al. Eur J Rheumatol. 2018 Dec.

Abstract

Up to 10% of systemic lupus erythematosus (SLE) cases are drug-induced; hence, they are called drug-induced lupus syndrome (DILS). Antinuclear antibody (ANA) should be present to diagnose SLE and DILS. ANA-negative lupus is very rare; therefore, it presents a diagnostic challenge. In the medical literature, two cases of ANA-negative hydralazine-induced lupus syndrome (HILS) have been described within the last year. Here, we present the third such case of HILS with negative ANA serology in a patient who developed considerable pericardial effusion. The association between ANA-negative HILS and pericardial effusion warrants future research.

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Conflict of interest statement

Conflict of Interest: The authors have no conflict of interest to declare.

Figures

Figure 1
Figure 1
Computed Tomography with contrast images of the chest, abdomen, and pelvis in the coronal section at presentation *denotes pericardial effusion; note the circumferential pericardial effusion surrounding the heart
Figure 2. a, b
Figure 2. a, b
Two-dimensional echocardiogram (ECHO) parasternal long-axis image (a) at presentation and (b) at 3-month follow-up *denotes pericardial effusion; RV: right ventricle; LV: left ventricle; LA: left atrium
See this image and copyright information in PMC

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