Several drugs2) are known to produce a lupus erythematosus-like syndrome including hydralazine hydrochloride, isonicotinic acid (isoniazid), anticonvulsants(hydantoin, trimethadione) and sulfonamides.
Since Ladd1) in 1962 first reported a procainamide induced systemic lupus erythematosus-like syndrome, many additional reports and studies have been performed3-23). The syndrome was characterized by involvement of many systems and included various combinations of fever, skin rash, myalgia, arthralgia and arthritis, pericarditis, pleuritis, splenomegaly, hepatomegaly and abnormalities of serum and blood such as VDRL, antinuclear antibody, RA factor, LE cell, and Coombs test. It developed in patients receiving procainamide and abated on discontinuation of the drug.
The purpose of this paper is to present "a case of procainamide induced SLE-like syndrome" as a side effect of procainamide reported few in Korean literature, which is unlikely due to mitral heart disease. This patient was a 65 years old housewife suffered from mitral insufficiency with dysrhythmia such as aerial fibrillation, premature ventricular contraction and recurrent ventricular tachycardia and received procainamide 2,000~3,000 mg daily for 15 months. Arthralgia and pleuritic chest pain were developed. The LE cell preparations (6X) were positive and ANA test (2X) revealed significant high titer. The clinical symptoms and serologic abnormalities were compatible with SLE. After discontinuation of the procainmide, the symptoms and serologic abnormalities returned to normal which confirmed the diagnosis.
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