Volume 4 • Issue 1 • 1000138 J Drug Metab Toxicol ISSN: 2157-7609 JDMT, an open access journal Research Article Open Access Mohammed et al., J Drug Metab Toxicol 2013, 4:1 http://dx.doi.org/10.4172/2157-7609.1000138 Research Article Open Access Drug Metabolism & Toxicology *Corresponding author: Mohammed Elimam Ahamed, Department of Biochemistry, Faculty of Medicine, International University of Africa, Khartoum, Sudan, E-mail: mohammedelimam@yahoo.com Received January 15, 2013; Accepted January 28, 2013; Published January 30, 2013 Citation: Mohammed EA, Sharief Nawahil A, Sumaia A, Mohamed Abdelrahim O (2013) Tamoxifen-Induced Lupus Erythematosus. J Drug Metab Toxicol 4: 138. doi:10.4172/2157-7609.1000138 Copyright: © 2013 Mohammed EA, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Introduction: Anti Nuclear Antibodies are one of the auto antibodies which are involved in screening, diagnosis and pathology of some auto and non autoimmune and drug induced diseases including Lupus Erythrymatosus. Objectives: The aim of this study is to investigate, if there is any correlation between tamoxifen side effects and the blood levels of Anti Nuclear Antibodies as a consequence of drug-induced lupus erythematosus. Methods: Twenty-eight breast cancer patients under tamoxifen therapy were involved in this study and compared to 11 newly diagnosed breast cancer patients who did not receive any therapy. 5 mls of intravenous blood were collected from the subjects after informed consent was obtained. The plasma was separated and the ANA levels were determined using ELISA. Results: Seventeen patients under tamoxifen were found with high level of ANA while 11 patients were with normal levels of ANA. However, the mean ANA plasma level in patients under tamoxifen therapy was 155.39 U/ml (9.4-911.7 U/ml) compared to 11.31 U/ml (0.9-29 U/ml) in the newly diagnosed patients; the ANA level signiicantly increased (p value was 0.017). The patients under tamoxifen therapy were divided to ive groups according to the number of tamoxifen therapies they received. Group 1 of 4 patients: received one tamoxifen therapy, group 2 of 6 patients: received three therapies, group 3 of 5 patients: received 5 therapies, group 4 of 9 patients: received 6 therapies and group 5 of 4 patients: received therapies ≥ 10. When the means of ANA concentration were compared to the mean of the newly diagnosed patients the p values were 0.88, 0.26, 0.09, 0.04 and 0.17 respectively. Conclusions: This study concluded that, although tamoxifen therapy did not affect the ANA level in all the patients, it signiicantly increased the blood level of ANA. Tamoxifen-Induced Lupus Erythematosus Mohammed Mohammed EA 1 *, Sharief Nawahil A 2 , Abukashawa Sumaia 2 and Mohamed Abdelrahim O 3 1 Department of Biochemistry, Faculty of Medicine, International University of Africa, Khartoum, Sudan 2 Department of Zoology, Faculty of Science, University of Khartoum, Sudan 3 Department of Biochemistry, Faculty of medicine, University of Khartou, Sudan Keywords: Hormonal therapy; ANA; Breast cancer; Sudanese subjects; Tamoxifen Introduction Tamoxifen is an antagonist of estrogen receptor in breast tissues and it is agonist of estrogen receptor in endometrium [1]. It has been the standard endocrine (anti-estrogen) therapy for hormone receptor-positive breast cancer in pre and postmenopausal women, although aromatase inhibitors have been proposed. Tamoxifen and its metabolites bind the estrogen receptor and inhibit the binding of estrogen leading to inhibition of cell growth. Some studies showed that Tamoxifen has anti angiogenesis activity besides blocking of the estrogen receptor [2]. It is known that Tamoxifen has a number of side efects including its efect on inhibiting osteoclasts leading to prevention of osteoporosis [3], increasing the risk of endometrial cancer [4], increasing blood level of triacylglycerols and its medical complications and increasing the risk of fatty liver [5]. Drug-induced lupus erythematosus is an autoimmune disorder that is brought on by a reaction to medication. It is caused by a hypersensitivity reaction to a medication. he drug may react with cell materials, causing the body to form antibodies that attack the body’s own healthy cells. he autoantibodies are known as Anti Nuclear Antibodies (ANA). Persons with drug-induced lupus erythematosus may have symptoms that afect the joints (arthritis), heart, lungs, kidney and nervous system [6]. Antinuclear antibodies (ANAs) are a speciic class of autoantibodies that are secreted in response to destroyed or dead cells, with two subtypes; Autoantibodies against DNA and histones and Autoantibodies to extractable nuclear antigens. ANA were discovered and found to be associated with diagnosis of diferent diseases including connective tissue diseases [7]. he ANA test is frequently used as one criterion for the screening and diagnosis of lupus erythematosus (LE) [8]. However, high blood levels of ANA were found among breast cancer patients [9]. he objective of this study is to investigate, if there is any correlation between tamoxifen side efects and the blood levels of Anti Nuclear Antibodies as a consequence of drug-induced lupus erythematosus. Patients, Material and Methods Study population 28 Sudanese patients with breast cancer under tamoxifen therapies sufering from fever, joint pain and loss of appetite (symptoms of drug-induced lupus erythematosus) were involved in this study and compared to eleven newly diagnosed breast cancer patients who did not receive any breast cancer treatment and without the mentioned symptoms. he range of age of patients under treatment was (30-84) and the mean was 52.3 while the age range of the control subjects was (30-73) and their mean was 51.