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. 1982 Mar 27;284(6320):936–939. doi: 10.1136/bmj.284.6320.936

Hydralazine, antinuclear antibodies, and the lupus syndrome.

R Mansilla-Tinoco, S J Harland, P J Ryan, R M Bernstein, C T Dollery, G R Hughes, C J Bulpitt, A Morgan, J M Jones
PMCID: PMC1496454  PMID: 6802356

Abstract

The incidence of patients with positive antinuclear antibody test results rose during three years of treatment with hydralazine. At the end of that period over half of the patients (both rapid and slow acetylators) had titres exceeding 1/20, but the rate of rise was faster in the slow acetylators than in the rapid. There was a significant relation between the cumulative dose of hydralazine and the proportion of patients found to have antinuclear factors. Fewer black patients had positive test results than white. Patients whose antinuclear antibody test results changed fron negative to positive during the study showed this change five to 26 months after beginning treatment. Some patients showed a substantial fall in antinuclear antibody titre even though hydralazine was continued. From these findings patients in whom test results for antinuclear antibody became positive during treatment with hydralazine need not have the drug stopped unless they have clinical features of the lupus syndrome.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Batchelor J. R., Welsh K. I., Tinoco R. M., Dollery C. T., Hughes G. R., Bernstein R., Ryan P., Naish P. F., Aber G. M., Bing R. F. Hydralazine-induced systemic lupus erythematosus: influence of HLA-DR and sex on susceptibility. Lancet. 1980 May 24;1(8178):1107–1109. doi: 10.1016/s0140-6736(80)91554-8. [DOI] [PubMed] [Google Scholar]
  2. Bresnihan B., Bunn C., Snaith M. L., Hughes G. R. Antiribonucleoprotein antibodies in connective tissue diseases: estimation by counterimmunoelectrophoresis. Br Med J. 1977 Mar 5;1(6061):610–611. doi: 10.1136/bmj.1.6061.610. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Condemi J. J., Moore-Jones D., Vaughan J. H., Perry H. M. Antinuclear antibodies following hydralazine toxicity. N Engl J Med. 1967 Mar 2;276(9):486–491. doi: 10.1056/NEJM196703022760902. [DOI] [PubMed] [Google Scholar]
  4. DUSTAN H. P., TAYLOR R. D., CORCORAN A. C. Rheumatic and febrile syndrome during prolonged hydralazine treatment. J Am Med Assoc. 1954 Jan 2;154(1):23–29. doi: 10.1001/jama.1954.02940350025006. [DOI] [PubMed] [Google Scholar]
  5. Evans D. A. An improved and simplified method of detecting the acetylator phenotype. J Med Genet. 1969 Dec;6(4):405–407. doi: 10.1136/jmg.6.4.405. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. FARR R. S. A quantitative immunochemical measure of the primary interaction between I BSA and antibody. J Infect Dis. 1958 Nov-Dec;103(3):239–262. doi: 10.1093/infdis/103.3.239. [DOI] [PubMed] [Google Scholar]
  7. Fessel W. J. Systemic lupus erythematosus in the community. Incidence, prevalence, outcome, and first symptoms; the high prevalence in black women. Arch Intern Med. 1974 Dec;134(6):1027–1035. [PubMed] [Google Scholar]
  8. Hansson L., Olander R., Aberg H., Malmcrona R., Westerlund A. Treatment of hypertension with propranolol and hydralazine. Acta Med Scand. 1971 Dec;190(6):531–534. doi: 10.1111/j.0954-6820.1971.tb07470.x. [DOI] [PubMed] [Google Scholar]
  9. PERRY H. M., Jr, SCHROEDER H. A. Syndrome simulating collagen disease caused by hydralazine (Apresoline). J Am Med Assoc. 1954 Feb 20;154(8):670–673. doi: 10.1001/jama.1954.02940420032009. [DOI] [PubMed] [Google Scholar]
  10. Perry H. M., Jr Late toxicity to hydralazine resembling systemic lupus erythematosus or rheumatoid arthritis. Am J Med. 1973 Jan;54(1):58–72. doi: 10.1016/0002-9343(73)90084-3. [DOI] [PubMed] [Google Scholar]
  11. Perry H. M., Jr, Tan E. M., Carmody S., Sakamoto A. Relationship of acetyl transferase activity to antinuclear antibodies and toxic symptoms in hypertensive patients treated with hydralazine. J Lab Clin Med. 1970 Jul;76(1):114–125. [PubMed] [Google Scholar]
  12. Siegel M., Lee S. L. The epidemiology of systemic lupus erythematosus. Semin Arthritis Rheum. 1973;3(1):1–54. doi: 10.1016/0049-0172(73)90034-6. [DOI] [PubMed] [Google Scholar]
  13. Strandberg I., Boman G., Hassler L., Sjöqvist F. Acetylator phenotype in patients with hydralazine-induced lupoid syndrome. Acta Med Scand. 1976;200(5):367–371. doi: 10.1111/j.0954-6820.1976.tb08248.x. [DOI] [PubMed] [Google Scholar]

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