A 36-year-old woman with severe chronic hypertension has been treated with hydralazine 100 mg twice daily for six months. She now presents with arthralgias, myalgias, low-grade fever (38.2°C), and a malar-like rash across her cheeks. Vital signs show BP 158/102 mmHg, HR 88, RR 16, and SpO2 98%. Laboratory testing reveals positive anti-histone antibodies, elevated ESR (65 mm/hr), and a normal complement level. Physical examination reveals mild bilateral wrist tenderness without synovial swelling. She has no photosensitivity or discoid lesions. Which medication most likely caused this drug-induced lupus-like syndrome?
- A)Hydrochlorothiazide
- B)Amlodipine
- C)Losartan
- D)HydralazineGABARITO
- E)Nitroglycerin
Explicação
Hydralazine can cause drug-induced lupus, classically associated with anti-histone antibodies. It is a direct arteriolar vasodilator used for hypertension and, in some settings, heart failure. The combination of chronic antihypertensive therapy and lupus-like ... Ver explicação completa e trilha adaptativa →