Serologic Evaluation of Patients Receiving Procainamide

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Abstract
This controlled study examined the characteristics of serologic abnormalities in 52 patients receiving procainamide for cardiac arrhythmias, who had no symptoms of a connective tissue disease. Antinuclear antibodies occurred in 43 patients (83%). Significant elevation of antibody binding to single‐stranded DNA (mean ± SEM 30 ± 2.6%), double‐stranded DNA (13 ± 1.1%), Z‐DNA (optical density 0.54 ± 0.06), and poly A (7.2 ± 0.6%) was seen (P < 0.001). Thirty‐four patients (65.4%) had antibodies to total histones, most frequently, the H2A/2B dimer. IgG antibodies to H2A/2B correlated with the cumulative procainamide dose. One patient subsequently developed drug‐related lupus.