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November 17, 1962

Clinical Science

JAMA. 1962;182(7):726-729. doi:10.1001/jama.1962.03050460018005

Hydralazine Lupus Syndrome Associated with a Possible Antihydralazine Antibody  William I. Heine, M.D., and Herman Friedman, Ph.D., PhiladelphiaSYSTEMIC LUPUS ERYTHEMATOSUS (SLE) is a disease thought to have a possibly hypersensitivity or immunologic basis. Patients with SLE show a spectrum of antinucleoprotein antibodies which may be detected by the LE cell test and by serological procedures.1 Attention has been called to the apparent production of SLE by an ever-increasing number of commonly used drugs.2,3 Included among these are hydralazine hydrochloride, penicillin, phenylbutazone, sulfadiazine, methylphenylethylhydantoin, trimethadione, and sulphamethothoxypyridazine.Hydralazine hydrochloride ( 1-hydrazinophthalazine) was introduced in 1951 for the treatment of hypertension. Beginning in 1954, there have been numerous reports4-10 of the occurrence of a lupuslike syndrome (hydralazine lupus syndrome) in about 10% of patients receiving hydralazine hydrochloride, usually after a year or more of daily doses exceeding 400 mg. The concept that SLE is associated with development of autoantibodies

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Dustan, H. P., et al.:  Rheumatic and Febrile Syndrome During Prolonged Hydralazine Treatment ,  JAMA 154:23, 1954.Crossref
Perry, H. M., Jr., and Schroeder, H. A.:  Syndrome Simulating Collagen Disease Caused by Hydralazine (Apresoline) ,  JAMA 154:640, 1954.Crossref
Reinhardt, D. J., and Waldron, J. M.:  Lupus Erythematosus-Like Syndrome Complicating Hydralazine (Apresoline) Therapy ,  JAMA 155:1491, 1954.Crossref
Shackman, N. H.; Swiller, A. I.; and Morrison, M.:  Syndrome Simulating Acute Disseminating Lupus Erythematosus; Appearance after Hydralazine Therapy ,  JAMA 155:1492, 1954.Crossref
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Hildreth, E. A.; Biro, C. E.; and McCreary, T. A.:  Persistence of "Hydralazine Syndrome,"  JAMA 173:657, 1960.Crossref
Comens, P.:  Hydralazine Lupus Syndrome , pp. 190, in  Inflammation and Diseases of Connective Tissue . Hahnemann Symposium, edited by Mills, L. E., and Moyer, J. H., Philadelphia: W. B. Saunders Co., 1961.
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Perry, H. M.: Personal communication, 1962.
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Braverman, I., and Lerner, A. B.: Unpublished data.