The Drug-Induced Respiratory Disease Website

Ustekinumab

Lupus - Lupus syndrome

Patients with drug-induced lupus may present with serositis (See Vd). Review at PMID 20015613. Compendium of 118 drugs causing lupus from the Who Phamacovigilance Database available at PMID 30793701. A few drugs (Penicillamine, IFN, anti-TNF agents) can cause +ds-DNA lupus. Drug withdrawal is followed by abatement of signs, symptoms and diminution or disappearance of anti-nuclear antibodies (ANA). See also under Vd.

Publications

Hirschmann S, Fischer S, Klenske E, Dechant K, Distler JHW, Treutlein C, Neurath MF, Atreya R

Case report of severe constrictive perimyocarditis and ischemic hepatitis in a Crohn's disease patient upon infliximab-induced lupus-like syndrome.

Therapeutic advances in gastroenterology 2021;14;17562848211044033 — 2021 — 17562848211044033

Moretta G, Caldarola G, Potenza A, Peris K, De Simone C

A case of chronic disseminated lupus erythematous in a psoriatic patient receiving ustekinumab.

Giornale italiano di dermatologia e venereologia : organo ufficiale, Societa italiana di dermatologia e sifilografia 2018 Nov 09;; — 2018 Nov 09

Diagnosing DIRD

Drug and radiation history

Drug singularity - Correct identification of the drug

Consistent timing of exposure v. onset of symptoms

Clinical, imaging, BAL, pathological pattern consistent with the specific drug

Careful exlusion of another cause

Remission of symptoms with removal of drug

Recurrence with rechallenge (rarely advisable)

Causality assessment

Diagnosing DIRD

Identify causative drugs

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