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Hydralazine-induced Lupoid syndrome. Biochemical and immunological studies.

. A patient suffering from generalized scleroderma. who was on treatment with hydralazine (Hy), has been followed up biochemically and immunologically before, during and after the onset of a lupoid syndrome. A serum precipitation test, which was strongly positive in the acute phase of the condition, is presented. No precipitation was obtained using sera of other patients with scleroderma or SLE or of controls. Low urinary values of sodium, potassium, calcium, phosphate and urea were noticed in relation to the crisis. A steep increase of the urinary output of acid mucopolysaccharides coincided, while no significant changes in collagen metabolites were noticed. Urinary creatinine values were normal. Increased IgM and IgG were found in the solubilized precipitate of patient serum and the Hy-DNA complex after removal of DNA with protamine sulphate. In the skin biopsy obtained during the crisis, IgM and small quantities of complement were demonstrated by the direct immunofluorescence technique. By immunodiffusion the presence of precipitating antibodies against DNA was shown.