Which drug can cause lupus-like syndrome and pericarditis?

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Hydralazine can trigger a drug-induced lupus-like syndrome that often comes with serositis, including pericarditis. The risk is higher in slow acetylators, who metabolize hydralazine more slowly, allowing the drug to accumulate and promote autoantibody formation—particularly anti-histone antibodies. Clinically you may see lupus-like symptoms such as arthralgias and fever, but with the added feature of serositis presenting as pericardial involvement. Lab testing often shows a positive ANA and anti-histone antibodies, while anti-dsDNA is typically absent. The key management step is stopping hydralazine, after which symptoms usually improve over weeks to months; NSAIDs can help with serositis symptoms and corticosteroids may be needed for more severe cases. Other drugs listed don’t characteristically cause this lupus-like syndrome with pericarditis, so they aren’t the best fit for this presentation.