A renal biopsy may be necessary because membranous proliferative and necrotizing glomerulonephritis may be present. Rare cases of death associated with DILE have been reported as a direct result of renal complications. Minocycline-associated lupus erythematosus has been associated with hepatic necrosis. Care must be taken to correctly diagnose that the symptoms of LE are indeed drug-induced rather than the systemic autoimmune disease.
Antinuclear antibodies are present.
There was no previous history of SLE prior to using the culprit drug. The drug was taken anywhere from 3 weeks to 2 years prior to the appearance of symptoms. Clinical improvement is rapid when the drug is discontinued, while antinuclear antibodies and other serologic markers slowly decrease toward more normal levels. A medication may induce the symptoms of LE by triggering the patient's immune system to manufacture antibodies directed against the patient's own tissues. The general mechanism is that a drug is metabolized into an antigenic compound that the patient's immune system determines to be foreign or harmful.