American Board of Internal Medicine (ABIM) Certification Practice Exam

How long after discontinuation of the offending agent do symptoms of drug-induced lupus erythematosus typically resolve?

1. Days

2. One to two weeks

3. Several weeks to months

4. Indefinitely

The correct answer is: Several weeks to months

Drug-induced lupus erythematosus (DILE) is a condition that can occur as a result of certain medications that lead to symptoms resembling systemic lupus erythematosus (SLE). The key to managing DILE is recognizing and discontinuing the offending agent. Typically, after stopping the medication responsible for triggering DILE, symptoms may not resolve immediately. In most cases, the symptoms take several weeks to months to completely improve. This timeframe is due to the persistence of the drug metabolites in the system and the immune system's gradual return to baseline functionality. In contrast, symptoms that resolve in a matter of days or within one to two weeks may indicate alternative diagnoses or a less severe drug reaction rather than DILE. An indefinite duration for symptom resolution does not reflect the nature of DILE, as it is reactive to the discontinuation of the drug, and symptoms usually do not last longer than a few months. This understanding aligns with the typical clinical course of DILE and aids in both the management and patient education regarding the condition.