Lupus erythematosus with leflunomide: induction or reactivation?

Ann Rheum Dis. 2005 Jan;64(1):153-5. doi: 10.1136/ard.2003.019323.

Abstract

Background: Leflunomide is a new oral disease modifying antirheumatic drug with a good safety profile.

Case report: The first case of lupus erythematosus in a 58 year old white woman after administration of leflunomide for primary Sjögren's syndrome is reported. The relationship between induced lupus and leflunomide was confirmed by the resolution of the skin rash when the drug was stopped and its recurrence when it was reintroduced following a dose-response effect.

Discussion: Peripheral blood cells from this patient, from 15 patients with rheumatoid arthritis, and from healthy controls were used in a bioassay, which suggested that leflunomide affected the Th1/Th2 balance. Such a side effect might be related, in part, to the anti-tumour necrosis factor alpha activity of leflunomide.

Publication types

  • Case Reports

MeSH terms

  • Antirheumatic Agents / adverse effects*
  • Antirheumatic Agents / therapeutic use
  • Drug Eruptions / etiology*
  • Drug Eruptions / immunology
  • Female
  • Humans
  • Isoxazoles / adverse effects*
  • Isoxazoles / therapeutic use
  • Leflunomide
  • Lupus Erythematosus, Cutaneous / chemically induced*
  • Lupus Erythematosus, Cutaneous / immunology
  • Lupus Erythematosus, Cutaneous / pathology
  • Middle Aged
  • Sjogren's Syndrome / drug therapy*
  • Th1 Cells / drug effects

Substances

  • Antirheumatic Agents
  • Isoxazoles
  • Leflunomide