Sykalo Christine, Al-Rubaye Riyahd, Chew Christopher R, Asreb Abdullah
Cardiology, Northeast Georgia Medical Center Gainesville, Gainesville, USA.
Internal Medicine, Northeast Georgia Medical Center Gainesville, Gainesville, USA.
Cureus. 2024 Oct 22;16(10):e72147. doi: 10.7759/cureus.72147. eCollection 2024 Oct.
Hydralazine has been used for decades for the management of hypertension. However, hydralazine has been associated with various side effects, including autoimmune diseases such as hydralazine-induced antineutrophil cytoplasmic antibody-associated vasculitis (ANCA-vasculitis) and lupus-like syndrome characterized by multiorgan involvement and complex clinical manifestations. We present four cases of hydralazine-induced vasculitis (sometimes referred to as drug-induced lupus or DIL) with different presentations, including diffuse alveolar hemorrhage, hemoptysis, and skin rash. Based on variable manifestations, diagnosis can be difficult, and a high index of suspicion is of paramount importance. The final diagnosis is made by kidney biopsy, and treatment includes discontinuation of the offending agent and frequent immunosuppression. We urge caution with the use of hydralazine and choosing alternative antihypertensives when possible.
肼屈嗪已被用于治疗高血压数十年。然而，肼屈嗪与多种副作用相关，包括自身免疫性疾病，如肼屈嗪诱导的抗中性粒细胞胞浆抗体相关性血管炎（ANCA血管炎）和以多器官受累及复杂临床表现为特征的狼疮样综合征。我们报告了4例肼屈嗪诱导的血管炎（有时称为药物性狼疮或DIL），表现各异，包括弥漫性肺泡出血、咯血和皮疹。基于多变的表现，诊断可能困难，高度怀疑至关重要。最终诊断通过肾活检做出，治疗包括停用致病药物并频繁进行免疫抑制。我们敦促谨慎使用肼屈嗪，并尽可能选择其他抗高血压药物。
