Which antihypertensive medication is known to be associated with a lupus-like syndrome?

Hydralazine is known to be associated with a lupus-like syndrome, which is a drug-induced condition that can present with symptoms mimicking systemic lupus erythematosus (SLE). This phenomenon is thought to occur due to the drug's chemical structure and its ability to induce an autoimmune response, leading to the production of antinuclear antibodies (ANAs) and potentially other autoantibodies. Clinically, patients may experience symptoms such as fever, arthralgia, myalgia, and serositis, resembling those found in SLE.

This reaction is dose-dependent, meaning that the likelihood of developing the syndrome increases with higher doses of hydralazine, often exceeding 200 mg per day. Importantly, the lupus-like syndrome is reversible upon discontinuation of the medication.

Other antihypertensive agents listed, such as labetalol, nicardipine, and nitroglycerin, do not have the same association with lupus-like syndromes. Labetalol primarily functions as a beta-blocker and alpha-1 antagonist without the same risk of inducing an autoimmune response. Nicardipine is a calcium channel blocker that is also not linked to this specific adverse effect. Nitroglycerin, a nitric oxide