A 29-year-old man comes to the physician for a follow-up examination. He has fatigued and low-grade fever for several days. He also has had muscle aches and severe joint pain in his elbows, wrists, and knees for the past 10 days. Three months ago, he was diagnosed with pulmonary tuberculosis and started on antituberculosis therapy. He has no current respiratory symptoms apart from pleuritic chest pain. The patient has no other significant past medical or family history. His examination is unremarkable. Laboratory results are as follows: An abnormality in which of the following metabolic processes most likely underlies this patient's current condition?

Question

A 29-year-old man comes to the physician for a follow-up examination. He has fatigued and low-grade fever for several days.  He also has had muscle aches and severe joint pain in his elbows, wrists, and knees for the past 10 days. Three months ago, he was diagnosed with pulmonary tuberculosis and started on antituberculosis therapy. He has no current respiratory symptoms apart from pleuritic chest pain. The patient has no other significant past medical or family history.  His examination is unremarkable. Laboratory results are as follows:  An abnormality in which of the following metabolic processes most likely underlies this patient's current condition?

Quizplus · Accepted Answer

Eductional Objective: Drug-induced lupus erythematosus (DILE) is characterized by constitutional symptoms : fatigue, fever, and weight loss usually manifest after 1 month of medication initiation. 
Presence of a genetic mutation in DILE that causes decreased acetyltransferase activity, which results in the slow acetylation of drugs. It has been linked to drugs metabolized by N-acetylation in the liver (eg, procainamide, hydralazine, isoniazid).

A 29-Year-Old Man Comes to the Physician for a Follow-Up