Typical Laboratory Findings

As in idiopathic lupus, antinuclear antibodies (ANAs) are almost always present, and the pattern is usually homogenous. Although antibodies against single-stranded DNA are common, unlike idiopathic lupus, antibodies against double-stranded DNA are uncommon. Antihistone antibodies are classic (Fritzler and Tan 1978); however, they are not diagnostic because they are often present in idiopathic lupus, and the exact specificity is even different for lupus caused by different drugs (Burlingame and Rubin 1991, Portanova et al. 1987). Antineutrophil cytoplasmic antibodies, many with specificity for myeloperoxidase, are common (Dunphy et al. 2000, Nassberger et al. 1990). These antibodies may activate neutrophils and increase inflammation (Falk et al. 1990). Mild anemia, leukopenia, and thrombocytopenia are common. Complement levels are usually normal,but they can be depressed (Rich 1996). When the offending drug is discontinued, manifestations such as anemia usually resolve with other symptoms. However, other laboratory manifestations of drug-induced lupus, such as ANAs, decrease with time but usually remain detectable for years.

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