Drug-induced lupus as a cause of relapsing inflammatory disease after renal transplantation.

Abstract

We discuss the case of an 18-year-old-boy presenting with relapsing fever, arthralgia, myalgia and renal failure, 7 yr after renal transplantation. A thorough diagnostic work-up for infectious and inflammatory diseases revealed a mastoiditis and atypical mycobacteria, but symptoms persisted after treatment. Persistent antinuclear antibodies in combination with cardiolipin and myeloperoxidase antibodies, despite negative dsDNA antibodies, suggested a drug induced lupus-like syndrome. Six months after withdrawal of dihydralazine, all symptoms had disappeared. Drug-induced lupus should be considered as an important differential diagnosis in transplanted patients with recurrent inflammatory disease in conjunction with lupus-like symptoms and negative dsDNA antibodies. It may prevent a potentially hazardous reduction of immunosuppression in persistent inflammation.

• Authors: Lars Pape, Juergen Strehlau, Kay Latta, Jochen Hh Ehrich, Gisela Offner
• Journal: Pediatric transplantation (Pediatr Transplant) Vol. 6 Issue 4 Pg. 337-9 (Aug 2002) ISSN: 1397-3142 [Print] Denmark
• PMID: 12234276 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antihypertensive Agents
• Dihydralazine

Topics

• Adolescent
• Antihypertensive Agents (adverse effects)
• Diagnosis, Differential
• Dihydralazine (adverse effects)
• Humans
• Kidney Transplantation
• Lupus Erythematosus, Systemic (chemically induced, diagnosis)
• Male
• Recurrence
• Syndrome