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VIGNETTES
The Utility of Antihistone Antibody Screening in the Diagnosis of Drug-Induced Lupus Erythematosus
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Antihistone antibodies (AHAs) are classically associated with drug-induced lupus erythematosus.1 However, multiple studies have revealed that AHAs are present with significant frequency in several other autoimmune diseases, including systemic lupus erythematosus unrelated to medications, rheumatoid arthritis, juvenile rheumatoid arthritis, primary biliary cirrhosis, autoimmune hepatitis, dermatomyositis/polymyositis, and scleroderma.2-3
In drug-induced lupus erythematosus a specific AHA (anti-[(H2A-H2B)-DNA] IgG) is produced, while in most of the other associated diseases (except systemic lupus erythematosus and scleroderma) the AHAs are of other varying specificities.4 Many of the other diseases that can manifest AHAs are significantly more common than drug-induced lupus erythematosus. Therefore, it seems likely that most patients with AHAs would not have drug-induced lupus erythematosus, in which case a positive screening test for AHAs would not be a reliable marker of drug-induced lupus erythematosus.
To test this hypothesis, we reviewed the results of AHA screening in our laboratory over the past 17 years.
Methods
All . . . [Full Text of this Article]
Results
Comment
Matthew J. Zirwas, MD;
Douglas W. Kress, MD
Pittsburgh
Jau-Shyong Deng, MD
Dermatology Service
VA Pittsburgh Healthcare System
Pittsburgh, PA 15240
(e-mail: jau-shyong.deng@med.va.gov)
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Antihistone Antibodies: Not as Useful as Hoped
Journal Watch Dermatology 2004;2004:4-4.
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