Ethosuximide-associated systemic lupus erythematosis in childhood

Systemic lupus erythematosis (SLE) is an autoimmune disorder that may be associated with antiepileptic drugs (AEDs). The postulated mechanisms of drug-related lupus (DRL) include either an unmasking of idiopathic SLE or the actual induction of autoantibodies. Although ethosuximide (ETH) is one of the drugs most implicated in childhood DRL, our treatment of a 13-year-old girl with ETH-associated DRL prompted a literature search that revealed only 15 other cases. Many of these were on multiple AEDs. We subsequently became aware of two other cases. The relationship of ETH to SLE in these three children is discussed, and clinical and laboratory features useful in the differentiation of various types of SLE are reviewed.