Borchers Andrea T, Keen Carl L, Gershwin M Eric
Division of Rheumatology, Allergy and Clinical Immunology, School of Medicine, University of California, Davis, California 95616, USA.
Ann N Y Acad Sci. 2007 Jun;1108:166-82. doi: 10.1196/annals.1422.019.
Drug-induced lupus (DIL) is a rare adverse reaction to a large variety of drugs with features resembling those of idiopathic systemic lupus erythematosus (SLE). It usually develops only after months and, quite commonly, years of treatment with the offending agent, although latencies of days or weeks have been described in some instances. There are some indications that the risk of DIL can increase with higher daily and cumulative doses and with longer duration of therapy. There are no definitive and commonly accepted diagnostic criteria for DIL, but the following guidelines have been proposed: (a) sufficient and continuing exposure to a specific drug, (b) at least one symptom compatible with SLE, (c) no history suggestive of SLE before starting the drug, and (d) resolution of symptoms within weeks (sometimes months) after discontinuation of the putative offending agent. In addition, it is frequently suggested that the presence of ANA is required for the diagnosis of DIL. However, negative ANA test results should not automatically preclude such a diagnosis, particularly if a patient has other autoantibodies associated with SLE/DIL.
药物性狼疮（DIL）是对多种药物的一种罕见不良反应，其特征与特发性系统性红斑狼疮（SLE）相似。它通常仅在使用致病药物数月乃至数年的治疗后才会出现，不过在某些情况下也有过数天或数周的潜伏期报道。有迹象表明，DIL的风险可能会随着每日剂量和累积剂量的增加以及治疗时间的延长而升高。目前尚无明确且被普遍接受的DIL诊断标准，但已提出以下指导原则：（a）充分且持续接触特定药物；（b）至少有一项与SLE相符的症状；（c）开始用药前无SLE病史；（d）停用疑似致病药物后数周（有时数月）内症状缓解。此外，人们常认为诊断DIL需要存在抗核抗体（ANA）。然而，ANA检测结果为阴性不应自动排除该诊断，特别是当患者有其他与SLE/DIL相关的自身抗体时。
