O. Andersson
2004
Citations
0
Influential Citations
5
Citations
Quality indicators
Journal
European Journal of Clinical Pharmacology
Abstract
A rare but severe side-effect of hydralazine therapy is a syndrome similar to systemic lupus (SLE). Cadralazine is a new vasodilating compound related to hydralazine but with the hydrazino group protected by an ethoxycarbonyl group [1]. This probably leads to it undergoing different metabolic pathways from those followed by hydralazine [2], which may be of importance in the pattern of side-effects. In theory, cadralazine should not cause SLE-like side-effects. The present case report supports this hypothesis. A 36year old man with moderate obesity and adult onset diabetes was treated with a beta-adrenergic blocking agent and hydralazine 100 mg t. i. d. He had previously developed side-effects whilst on prazosin and when on nifedipine. Thiazide diuretics were considered contraindicated because of the patient's impaired glucose tolerance. In October 1984 he developed arthritis, slight fever and had a positive ANA-test (1/320). The sedimentation rate was 88 mm. Hydralazine treatment was discontinued and was replaced by cadralazine 20 mg once daily as the vasodilator agent in combination with metoprolol 100 mg b. i. d. During the following 2 months the patient gradually recovered from the arthralgias and fever, the positive ANA disappeared, and the sedimentation rate became normal. He has now been treated with metoprolol and cadralazine for 12 months without side-effects and with good control of the blood pressure. Thus, cadralazine did not appear to provoke an SLE-like syndrome in a patient who had previously experienced immunological side-effects induced by hydralazine.