Although there have been case reports of a lupus-like syndrome associated with other P-blockers, the only two associated with a significant incidence are practolol and ace-butolol. Practolol was one of the first P-blockers, and it was associated with a lupuslike syndrome and an unusual occulo-mucocutaneous syndrome that led to its withdrawal (Raftery and Denman 1973). This led some people to suspect that it might be a class effect, and this increased suspicion about other drugs in this class. In one study, ANAs were found in eight of nine patients treated with acebutolol, and there are also case reports of acebutolol-induced lupus (Booth et al. 1982).As mentioned in the "Involvement of Reactive Metabolites" subsection, practolol and acebutolol are the only P-blockers that are readily metabolized to aromatic amines.

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