A Severe Presentation Of Drug Induced Lupus Erythematosus With Multi-Organ Involvement: A Rare Case Report

Drug induced lupus erythematosus (DILE) is a subset of lupus, defined as a lupus-like syndrome that develops in temporal relation to exposure to a drug and resolves after cessation of the drug exposure. It can be induced by various medications. The presentation is often vague and needs a high index of suspicion to diagnose this condition which has a potential to cause significant morbidity[1]. It should be distinguished from multi systemic, auto-immune systemic lupus erythematosus (SLE). The clinical manifestations of DILE are usually mild to moderate and are rarely severe [2]. We present a 31-year-old female with severe multi-system dysfunction probably due to drug-induced lupus erythematosus that required immunosuppressive therapy. Specific classification criteria for drug-induced lupus have not been published [3].Based on the WHO-UMC [4] and Naranjo’s causality assessment criteria[5], an association between the reaction and the offending drug was deemed possible. The reaction was severe (level 5) according to the Hartwig severity assessment scale [6].