Six months after starting a new antihypertensive, a 54-year-old woman develops arthralgias, malar rash, pleuritic chest pain, and fever. ANA is positive at high titre with anti-histone antibodies. Renal and CNS involvement are absent. Her symptoms resolve after the drug is stopped. Which drug caused this picture?
- A Amlodipine
- B Hydralazine ✓
- C Losartan
- D Atenolol
Correct answer: B. Hydralazine
Explanation
Hydralazine is a classic cause of drug-induced lupus, characterized by arthralgia, rash, serositis, positive ANA with anti-histone antibodies, and absence of renal or central nervous system involvement. Symptoms remit after withdrawal. Procainamide and minoxidil share this propensity among cardiovascular drugs. Calcium channel blockers, ARBs and beta blockers are not recognized triggers of drug-induced lupus, making the remaining options untenable despite being common antihypertensives.
Reference: Katzung's Basic and Clinical Pharmacology, 15th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.