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Abstract
Background: Drug-related lupus [DRL] especially with hydralazine has been known for 40 years. Signs and symptoms of DRL may be readily mistaken for other disorders such as fibromyalgia. The purpose of the case presentation is to review the pathophysiology and similarities between DRL and fibromyalgia in addition to emphasize the importance of accurate diagnosis in physiatric practice. Findings: This is a case of 57-year-old hypertensive woman on hydralazine for nine years who developed multiple complaints including bilateral chest pain, cough, shortness of breath, joint pain at knees and ankles, muscle pain in thighs and calf, swelling of hands and feet, intermittent skin lesions, depression and anxiety. She was referred to a physiatrist with the mistaken diagnosis of fibromyalgia. The patient's sings and symptoms were not diagnostic of DRL but were suspicious of something other than fibromyalgia. An immunological work-up showed suggestion of DRL and hydralazine was discontinued. Conclusion: Drug-related lupus may be misdiagnosed especially as fibromyalgia. Careful evaluation should lead to accurate diagnosis.