Hydralazine-induced lupus syndrome can present with recurrent pericardial effusion even in the absence of a positive antinuclear antibody, and resolves upon drug cessation.
Recurrent effusion may signal ANA-negative HILS in hydralazine users; extends DIL spectrum but leaves open revised diagnostic criteria.
Drug induced lupus erythematosus (DIL or DILE) is an autoimmune disorder caused by chronic use of certain drugs. We report a unique case of hydralazine induced lupus syndrome (HILS) with a negative antinuclear antibody in a female patient who was on hydralazine for a period of 1.5-2 years and developed recurrent pericardial effusion as a result of it. Initially her condition was managed with a pericardial window. The recurrence of a massive pericardial effusion necessitated a right hemipericardiectomy. After hydralazine was stopped, she never had any further episodes of pericardial effusion or tamponade.
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Iyer et al. (2017) studied this question.
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