Rheumatic and Febrile Syndrome During Prolonged Hydralazine Treatment

Recent experience has extended and confirmed our impressions of the effects of treatment of hypertension with hydralazine hydrochloride (1-hydrazinophthalazine, Apresoline 1 ) as the sole antipressor agent. 2 A favorable result is commonly observed; the untoward toxic side-effects, formerly described, appear and usually disappear as the drug is used. In the doses used, tolerance, which others 3 using smaller doses have observed, is rare. Some patients have become slightly anemic, partly, it would seem, as a result of anorexia, but severe anemia 4 is exceptional. Another striking complication of treatment has appeared in some of our patients; this seems to be related to the use of large doses of hydralazine over long periods of time. The syndrome in its less severe form resembles rheumatoid arthritis; in its severer febrile aspect, it simulates acute systemic lupus erythematosus. It is described in this report because of the natural interest attached to a complication