Autoimmunity: drug-induced lupus: practice question

A Pathology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pathology · Autoimmunity: drug-induced lupus

Sample item

A 60-year-old man who has taken hydralazine for hypertension for 8 months develops arthralgia, fever and pleuritic chest pain. Renal and central nervous system functions are normal. Which antibody is most characteristic?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Anti-histone antibody

Hydralazine, procainamide and isoniazid can cause drug-induced lupus, which is typically mild with arthritis, serositis and fever, and with sparing of kidney and brain. Anti-histone antibodies are present in most cases, while anti-dsDNA and anti-Smith are usually absent. The syndrome resolves on stopping the drug.

Option by option

  • A. Anti-Ro antibody

    Anti-Ro is associated with Sjogren syndrome, subacute cutaneous lupus and neonatal lupus.

  • B. Anti-Smith antibody

    Anti-Smith is highly specific for idiopathic SLE.

  • C. Anti-double-stranded DNA antibody

    Anti-dsDNA is typical of idiopathic SLE and is usually absent in drug-induced lupus.

  • D. Anti-histone antibody (correct)

    Correct. Anti-histone antibodies are the hallmark of drug-induced lupus.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is D, Anti-histone antibody. Hydralazine, procainamide and isoniazid can cause drug-induced lupus, which is typically mild with arthritis, serositis and fever, and with sparing of kidney and brain.

Why is "Anti-Ro antibody" not the answer?

Anti-Ro is associated with Sjogren syndrome, subacute cutaneous lupus and neonatal lupus.

Why is "Anti-Smith antibody" not the answer?

Anti-Smith is highly specific for idiopathic SLE.

Why is "Anti-double-stranded DNA antibody" not the answer?

Anti-dsDNA is typical of idiopathic SLE and is usually absent in drug-induced lupus.

What concept does this question test?

It tests Autoimmunity: drug-induced lupus in Pathology. Anti-histone antibodies are present in most cases, while anti-dsDNA and anti-Smith are usually absent. The syndrome resolves on stopping the drug.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Autoimmunity: drug-induced lupus?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.