Abstract
Statins are among the most widely prescribed drugs. An increasing number of lupus-like syndrome has recently been reported with these lipid-lowering agents. We describe a new case associated with simvastatin therapy. The presence of anti-dsDNA antibodies in the serum is for the first time reported confirming that statins may also induce a systemic autoimmune reaction. Statin-induced lupus-like syndrome is characterized by the long delay between the beginning of therapy and the skin eruption. Antinuclear antibodies may persist for many months after drug discontinuation. The causal relationship may be therefore difficult to establish, and probably many cases are unrecognized. Early diagnosis may avoid unnecessary immunosuppressive therapy.
References
1.
Hanson J, Bossingham D: Lupus-like syndrome associated with simvastatin. Lancet 1998;352:1070.
2.
Srivastava M, Rencic A, Diglio G, et al: Drug-induced, Ro/SSA-positive cutaneous lupus erythematosus. Arch Dermatol 2003;139:45–49.
3.
Noël B, Cerottini JP, Panizzon RG: Atorvastatin-induced dermatomyositis. Am J Med 2001;110:670–671.
4.
Sridhar MK, Abdulla A: Fatal lupus-like syndrome and ARDS induced by fluvastatin. Lancet 1998;352:114.
5.
Mok CC, Lau CS: Pathogenesis of systemic lupus erythematosus. J Clin Pathol 2003;56:481–490.
6.
Mevorach D: Systemic lupus erythematosus and apoptosis: A question of balance. Clin Rev Allergy Immunol 2003;25:49–60.
7.
Baima B, Sticherling M: Apoptosis in different cutaneous manifestations of lupus erythematosus. Br J Dermatol 2001;144:958–966.
8.
Rovere P, Sabbadini MG, Fazzini F, et al: Remnants of suicidal cells fostering systemic autoaggression: Apoptosis in the origin and maintenance of autoimmunity. Arthritis Rheum 2000;43:1663–1672.
9.
Knapp AC, Huang J, Starling G, et al: Inhibitors of HMG-CoA reductase sensitize human smooth muscle cells to Fas-ligand and cytokine-induced cell death. Atherosclerosis 2000;152:217–227.
10.
Chapman-Shimshoni D, Yuklea M, Radnay J, et al: Simvastatin induces apoptosis of B-CLL cells by activation of mitochondrial caspase 9. Exp Hematol 2003;31:779–783.
11.
Trebeden-Negre H, Weill B, Fournier C, et al: B cell apoptosis accelerates the onset of murine lupus. Eur J Immunol 2003;33:1603–1612.
12.
Vial T, Nicolas B, Descotes J: Drug-induced autoimmunity: Experience of the French pharmacovigilance system. Toxicology 1997;119:23–27.
© 2004 S. Karger AG, Basel
2004
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