Would you favor stopping hydralazine in a patient requiring it for refractory hypertension if they also have a high titer ANA in the absence of any SLE symptoms?

In a patient who requires hydralazine and there are no alternatives (for example, using it for hypertensive emergency in pregnancy), I would not stop it.

1. Although a high percentage of hydralazine users become antinuclear antibody (ANA) positive, a much smaller percentage develop drug-induced lupus....

Completely agree. If hydralazine needs to be used, I would not hesitate in a patient with a positive ANA. Unclear if the ANA was positive prior to treatment in this patient, but we know many patients will become ANA-positive on medications like hydralazine without the development of DIL. I also agre...