Vaghela Jitendra H, Solanki Yogesh, Lakhani Krishna, Purohit Bhargav
Department of Pharmacology, Government Medical College, Bhavnagar, Gujarat, 364001, India.
Departmen of Medicine, Government Medical College and Sir Takhtsinhji General Hospital, Bhavnagar, Gujarat, 364001, India.
Drug Saf Case Rep. 2019 Sep 20;6(1):7. doi: 10.1007/s40800-019-0102-y.
Systemic lupus erythematosus (SLE) can be induced by various medications, such as hydralazine, procainamide, isoniazid, methyldopa, chlorpromazine, quinidine, and minocycline. A patient was admitted complaining of fever with chills and rigor. After being diagnosed with tuberculous meningitis, the patient was given antituberculosis treatment. As the patient did not improve, detailed investigations were conducted, and elevated antinuclear antibody levels were found. The consulting physician diagnosed that the patient was suffering from SLE. As isoniazid is associated with an increased risk of developing SLE, it was suspected as the culprit drug. After withdrawing isoniazid from the antituberculosis treatment regimen, the patient improved and was discharged. Based on the WHO-UMC and Naranjo's causality assessment criteria, an association between the reaction and isoniazid was deemed probable. The reaction was moderately severe (level 4b) according to the modified Hartwig and Siegel scale.
系统性红斑狼疮（SLE）可由多种药物诱发，如肼屈嗪、普鲁卡因胺、异烟肼、甲基多巴、氯丙嗪、奎尼丁和米诺环素。一名患者因发热伴寒战和高热入院。被诊断为结核性脑膜炎后，该患者接受了抗结核治疗。由于患者病情未改善，遂进行了详细检查，发现抗核抗体水平升高。会诊医生诊断该患者患有系统性红斑狼疮。由于异烟肼与发生系统性红斑狼疮的风险增加有关，怀疑其为致病药物。在抗结核治疗方案中停用异烟肼后，患者病情好转并出院。根据世界卫生组织药物不良反应监测中心（WHO-UMC）和纳兰霍因果关系评估标准，认为该反应与异烟肼之间可能存在关联。根据改良的哈特维希和西格尔量表，该反应为中度严重（4b级）。
