Hydralazine-induced autoimmune disease: comparison to idiopathic lupus and ANCA-positive vasculitis

Mod Rheumatol. 2009;19(3):338-47. doi: 10.1007/s10165-009-0168-y. Epub 2009 May 8.


We report two cases of hydralazine-induced vasculitis with rare complications: pulmonary renal syndrome and digital gangrene. We also review 68 published cases of hydralazine-induced vasculitis. Hydralazine-induced vasculitis mimics idiopathic antineutrophil cytoplasmic antibody (ANCA)-positive vasculitis. However, it also produces other autoantibodies, such as antinuclear antibodies, antihistone antibodies, anti-dsDNA antibodies, and antiphospholipid antibodies. Patients with hydralazine-induced vasculitis typically have a more severe course than those with hydralazine-induced lupus, predominantly due to renal vasculitis, and require a more aggressive treatment.

Publication types

  • Case Reports
  • Comparative Study
  • Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antibodies, Antineutrophil Cytoplasmic
  • Diagnosis, Differential
  • Female
  • Humans
  • Hydralazine / adverse effects*
  • Lupus Nephritis / chemically induced*
  • Lupus Nephritis / diagnosis*
  • Lupus Nephritis / physiopathology
  • Male
  • Vasculitis, Leukocytoclastic, Cutaneous / chemically induced*
  • Vasculitis, Leukocytoclastic, Cutaneous / diagnosis*
  • Vasculitis, Leukocytoclastic, Cutaneous / physiopathology
  • Vasodilator Agents / adverse effects*


  • Antibodies, Antineutrophil Cytoplasmic
  • Vasodilator Agents
  • Hydralazine