A patient who developed pulmonary hypertension and systemic lupus erythematosus as a complication of hydralazine therapy is reported. She was a slow acetylator and in addition was found to have a null allele at the C4A locus.

https://ard.bmj.com/content/annrheumdis/45/9/771.full.pdf

Pulmonary hypertension in hydralazine induced systemic lupus erythematosus: association with C4 null allele.

The well known HLA/disease associations have often in the past been attributed to the effects of Class 1 or 11 MHC products on an individual’s immune responsiveness. However there are reasons for thinking that more than one mechanism may be responsible for these associations. In this paper, we will outline the evidence which leads us to conclude that the Class 111 genes, encoding polymorphisms for the complement system proteins of C4A, C4B, and C2 govern susceptibility to systemic lupus erythematosus (SLE).

https://link.springer.com/content/pdf/10.1007%2F978-1-4612-5014-2_23.pdf

Class III HLA Genes and Systemic Lupus Erythematosus

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Class III HLA Genes and Systemic Lupus Erythematosus