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Acetylprocainamide Therapy in Patients with Previous Procainamide-Induced Lupus Syndrome

[+] Article, Author, and Disclosure Information

Grant support: in part by grants AM 25693 and RR 47 from the U. S. Department of Health and Human Services and grants from the Lupus Foundation, Queens, New York, and American Critical Care, Inc., McGaw Park, Illinois.

▸Requests for reprints should be addressed to Marcus M. Reidenberg, M.D.; Cornell University Medical College, 1300 York Avenue; New York, NY 10021.

New York, New York

© 1981 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1981;95(1):18-23. doi:10.7326/0003-4819-95-1-18
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Acetylprocainamide was used to treat 11 patients with previous procainamide-induced lupus syndrome for their cardiac arrhythmias. Three patients from whom procainamide had been withdrawn and whose lupus was in remission did not have a recurrence during a course of acetylprocainamide therapy of a longer average duration than their prior procainamide therapy. Lupus symptoms subsided during treatment in two patients who had symptoms when acetylprocainamide was started. Drug fever developed in one patient, and another had a mild recurrence of lupus symptoms during high-dose acetylprocainamide therapy that regressed with dosage reduction. All patients had small amounts of circulating procainamide from in-vivo deacetylation of acetylprocainamide. These observations strongly support the hypothesis that the aromatic amino group on procainamide is important for induction of the lupus syndrome and that acetylating this amino group blocks the lupus-inducing effect.





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