• Internal medicine · Mar 2023

    A Case of Severe Lupus Myocarditis Preceded by Mesalazine-induced Lupus.

    • Mai Yamashita, Keisuke Nishimura, Iku Shirasugi, Yoshihide Ichise, Yo Ueda, and Jun Saegusa.
    • Rheumatology and Clinical Immunology, Kobe University Graduate School of Medicine, Japan.
    • Intern. Med. 2023 Mar 15; 62 (6): 929933929-933.

    AbstractIn drug-induced lupus (DIL), symptoms similar to those of systemic lupus erythematosus (SLE) usually resolve after discontinuation of the offending drug. A 41-year-old-woman with a history of ulcerative colitis presented with polyarthritis and myositis and was positive for anti-double stranded (ds) DNA IgG antibody. After discontinuation of mesalazine, the symptoms resolved, and the antibody titer decreased. The patient was diagnosed with DIL. Six months later, lupus myocarditis developed. After treatment with glucocorticoids, cyclophosphamide, intravenous immunoglobulin, and an intra-aortic balloon pump, she showed dramatic improvement. Patients with DIL and an immunological predisposition, such as anti-dsDNA antibodies, may have SLE and should be carefully monitored.

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