This study aimed to elucidate the clinical features and temporal patterns of drug-induced lupus (DIL) associated with the stilbene amine antiepileptic drugs carbamazepine and oxcarbazepine. A comprehensive systematic review was conducted using multiple literature databases. Both domestic and international case reports of DIL linked to these agents were screened and analyzed. A total of 22 eligible cases were identified, comprising 19 cases related to carbamazepine and three to oxcarbazepine. Analysis revealed a mean patient age of 32.50 ± 16.08 years, with a marked female predominance (72.73%, 16/22). The latency period, the duration between drug initiation and the onset of DIL, was notably prolonged and variable, averaging 56.93 ± 75.57 months. Clinically, DIL presented as a multi-system disorder, with hematologic abnormalities (e.g., thrombocytopenia, anemia, and leukopenia) observed in 68.18% of cases, musculoskeletal symptoms (arthritis or joint pain) in 59.09%, and cutaneous involvement (rash or photosensitivity) in 54.55%. Following drug discontinuation and, in some instances, glucocorticoid therapy, clinical improvement was observed to varying degrees. Notably, 31.82% of patients experienced complete symptom resolution within 7 d. Given the insidious onset and multi-organ involvement of DIL, our findings underscored the importance of heightened clinical vigilance and routine monitoring protocols during antiepileptic drug therapy. This study highlighted the need for a dynamic risk-benefit assessment in the clinical use of antiepileptic drugs and provides valuable insights for the management of rare but serious neurological adverse reactions.
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