The Histone test serves to distinguish drug-induced lupus from other forms of lupus, such as systemic lupus erythematosus (SLE), from other autoimmune conditions, or from alternative sources of the patient's symptoms. Although it isn't a definitive diagnostic tool for drug-induced lupus, the presence of histone antibodies aligns with this diagnosis.
This test is typically ordered in conjunction with a positive antinuclear antibody (ANA) test and at times alongside an anti-double-stranded DNA (anti-dsDNA) test to aid in the establishment of a diagnosis.
Upon diagnosing drug-induced lupus, healthcare providers may recommend discontinuing the implicated drug. One or more histone antibody tests can then be employed to monitor antibody levels (titers), if present.
A histone antibody test is requested when an individual has been taking medication for several weeks to a few years and displays signs and symptoms that could be linked to drug-induced lupus. This situation is particularly relevant if the affected person lacks a prior personal or familial history of autoimmune disorders. Symptoms may encompass:
While systemic lupus erythematosus (SLE) can entail symptoms involving the central nervous system (CNS) and kidneys, these are much less common with drug-induced lupus.
After discontinuation of the drug, the histone antibody test may be repeated at intervals to monitor potential decreases in histone antibody levels.
A negative result suggests that the individual's symptoms could stem from a cause other than drug-induced lupus, such as a drug allergy. Nevertheless, a negative outcome does not definitively rule out drug-induced lupus. Some individuals might have drug-induced lupus despite lacking histone antibodies.
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A positive result means that a person likely has drug-induced lupus if the person also has:
- Symptoms associated with lupus
- Been taking a drug, especially one associated with the condition, for several weeks to a couple of years
- No identified autoimmune disorder prior to taking the drug
- Positive ANA test
- Low or negative anti-dsDNA and other autoantibodies
- Signs and symptoms that resolve when the drug is discontinued
- Histone antibody levels that begin to decrease when the drug is discontinued
A positive histone antibody result by itself does not establish a diagnosis. About 50% of those with SLE will have histone antibodies, though generally not induced by a specific drug. In these cases, the anti-dsDNA test will be positive and significantly elevated.
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