What are the Clinical manifestations of systemic Drug induced Lupus Erythematosus, and how do they differ from those of idiopathic SLE?
Patients with systemic DILE can develop a variety of signs and symptoms that typically come on abruptly. Similar to SLE, these include fever and/or other constitutional symptoms (50%), arthritis/arthralgias (80%–95%), myalgias, serositis (50% with procainamide, 25% with quinidine, unusual with others), hepatomegaly (5%–25%), and erythematous papular rashes (20%). Discoid lesions and malar erythema (2%) are uncommon. Some patients may develop pulmonary infiltrates (e.g., procainamide). More severe manifestations of SLE, such as cytopenias, nephritis, and central nervous system (CNS) involvement, are very rare in DILE, as are the presence of anti-double-stranded DNA (anti-dsDNA) antibodies and hypocomplementemia. One exception is that anti-tumor necrosis factor (TNF) agents and interferon-α (IFNα) can induce anti-dsDNA antibodies and hypocomplementemia in patients who develop systemic DILE caused by these medications.