Is lupus erythematosus, which can be cured, really exist?

Let's give you a good analysis of drug-induced lupus, as well as other diseases
that are easily confused with lupus.
”

01 Demystifying drug-induced lupus

Drug-induced lupus refers to lupus-like syndrome caused by taking a certain drug, and as the name suggests, certain drugs can cause the otherwise normal body to suddenly develop symptoms
similar to those of a person with lupus.

However, there are many epidemiological and clinical differences between drug-induced lupus and primary lupus:

Similar to SLE, the occurrence of drug-induced lupus is related to genetic factors, and identified risk factors include chronic acetylated constitution, HLA-DR4 genotype, HLA-DR0310 genotype, and complement C4 and other invalid alleles
.
These risk factors, combined with drug-specific properties, will influence the presentation
of patients with drug-induced lupus.

02 The "culprits" of drug-induced lupus

More than 80 classes of drugs are known to induce drug-induced lupus, and their characteristics and inducing drug-induced clinical features are different
.

According to the mechanism of action of drugs, these drugs can be divided into antiepileptic drugs, antiarrhythmics, antidepressants, antihypertensive drugs, tumor necrosis factor (TNF-α) antagonists, other antirheumatic drugs, antituberculosis drugs, antibiotics, antifungal drugs, interferon drugs, antineoplastic drugs, antithyroid drugs, proton pump inhibitors, and oral contraceptives
.

Due to the limited space, if you want to know the drug names, symptoms caused by the main representatives of the above drugs, and the performance of indicators related to lupus, you can scan the QR code below to reply to [Drug-induced Lupus] to receive the complete "detailed list of drugs that can induce lupus syndrome"
.

03 Against drug-induced lupus can do this

The basis of treatment of drug-induced lupus is discontinuation of the causative drug
.

For patients with drug-induced cutaneous lupus erythematosus-like manifestations, symptoms are generally relieved after a few weeks of discontinuation and do not require specific treatment
.
Individual patients require topical corticosteroids or calcineurin inhibitors in addition to discontinuation
.

In patients with drug-induced systemic lupus erythematosus-like presentations, the principles of treatment are the same
as SLE once systemic multisystem damage is caused by drug-induced lupus.
Only joint and muscle symptoms, can be controlled with nonsteroidal anti-inflammatory drugs; Short-term therapy with low-dose hormones may be indicated in patients with refractory cases or concomitant serositis; For patients with severe organ damage, hormone shock, even immune purification and other treatments should be given, and cyclophosphamide therapy should be combined with the above treatment to actively control the disease
.

With the wide application of more and more kinds of drugs in clinical practice, drug-induced diseases have also attracted more and more attention
.
Drug-induced lupus is not uncommon and deserves everyone's attention, and there are many drugs that can induce drug-induced lupus, and the clinical manifestations are diverse, which brings certain difficulties
to the diagnosis.
At the same time, it is also easy to interfere with the diagnosis of real SLE, so in addition to drug-induced lupus, what other diseases can make SLE misdiagnosed?

04 Those diseases that are easily confused with SLE

Unlike most diseases, SLE is an immune disease that can cause abnormalities in multiple organs, which are similar to common diseases, which not only deepens the difficulty of diagnosis by doctors, but also tends to cause contempt, slack and delay in medical treatment for patients
.

1.
Dermatomyositis

Patients with dermatomyositis have a characteristic facial lesion of a dark purplish-red edematous macule with both upper eyelids, sometimes occurring throughout the orbital area, but symmetrically occurring erythema is often seen on both cheeks, and sometimes difficult to distinguish
from the facial butterfly erythema of systemic lupus erythematosus.

2.
Nephrotic syndrome and glomerulonephritis

Some lupus have only nephritis at the beginning of the onset, but no other features of lupus, so it is difficult to identify, and even kidney tissue biopsy is difficult to distinguish whether it is simple nephrotic syndrome, glomerulonephritis, or lupus kidney
.
Lupus-specific immune indicators and other clinical manifestations should be comprehensively judged
.

3.
Connective tissue disease

Due to the immune response and inflammatory response caused by a class of diseases that occur in loose connective tissue, called connective tissue disease in the narrow sense, such diseases are easy to be confused with SLE, they mainly include drug-induced lupus, rheumatoid arthritis, systemic scleroderma and adult Still.

Rheumatoid arthritis: rheumatoid arthritis is mainly symmetrical wrist, metacarpophalangeal and proximal interphalangeal joint inflammation and pain, often accompanied by joint deformity, long morning stiffness, high rheumatoid factor titer and other symptoms
.

SLE mostly has facial skin lesions, mouth ulcers, kidney damage, positive for Sm antibodies, anti-ds-DNA antibodies and positive ANA with high titer, and no symptoms
of joint deformity.

Systemic scleroderma: Raynaud's phenomenon is a common complication in SLE in autumn and winter and needs to be differentiated
from patients with early-stage systemic scleroderma.
However, Raynaud's phenomenon in patients with lupus is mainly caused by narrowing of the lumen of blood vessels caused by vasculitis, and Raynaud's phenomenon can be reduced or disappeared
by treatment such as glucocorticoids.

The Raynaud's phenomenon in patients with systemic scleroderma does not disappear
even with treatment.

Still disease in adults: because it has fever and arthritis, it needs to be differentiated
from lupus erythematosus.
However, fever is often accompanied by a rash, and the rash is most common as a red wheal-like rash the size of bean or peanut rice, mainly distributed on the chest and proximal extremities
.
In addition, there will be abnormal manifestations of organs, such as liver, spleen, lymph node enlargement, increased white blood cells in the blood, neutrophilia, and bone marrow aspiration with infectious bone marrow image but negative blood culture, elevated serum ferritin, and other abnormalities
.