Nephropathy Induced by D-Penicillamine

Jaffe, Israeli A.; Treser, Gerhard; Suzuki, Yasunosuke; Ehrenreich, Theodore

doi:10.7326/0003-4819-69-3-549

Cited by 82 publications

(24 citation statements)

References 20 publications

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“…The subepithelial humps and electron-dense de posits. seen in the specimens obtained from our patient, are consistent with poststreptococcal glomerulonephritis [8], but are also characteristic of renal lesions caused by /7-penicillamine [9][10][11][12]. In a study of 6 patients with Dpenicillamine-induced nephropathy, all renal biopsies showed subepithelial electron-dense deposits, that appear first on the epithelial side of the basement membrane and then are covered by overlying epithelial cells [13].…”

Section: Discussionmentioning

confidence: 66%

Rapidly Progressive Glomerulonephritis in a Patient with Rheumatoid Arthritis during Treatment with High-Dosage <i>D</i>-Penicillamine

et al. 1985

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A patient with advanced rheumatoid arthritis and severe clinical manifestations of rheumatoid vasculitis died of acute renal failure after 30 months of treatment with high-dosage D-penicillamine. She had had no signs of adverse drug reactions until the terminal illness. Although streptococcal pharyngitis was diagnosed late in her disease, penicillamine-induced immune complex glomerular damage is considered more likely than poststreptococcal glomerulonephritis, because her microscopic hematuria preceded diagnosis of pharyngitis. Postmortem examination disclosed findings suggestive of rapidly progressive glomerulonephritis of immune complex pathogenesis. The short period of microscopic hematuria and the rapidity of development of renal failure before death emphasize the need for frequent monitoring of renal function and prompt discontinuation of D-penicillamine treatment upon detection of otherwise unexplained hematuria. There is urgent need for early immunological evaluation, renal biopsy, and vigorous therapeutic measures.

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Section: Discussionmentioning

confidence: 66%

Rapidly Progressive Glomerulonephritis in a Patient with Rheumatoid Arthritis during Treatment with High-Dosage <i>D</i>-Penicillamine

et al. 1985

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“…T h e two major side effects which do not appear to have been favorably influenced by the graduated dosage program are an alteration in the sense of taste (hypogeusia) (12) and nephropathy (13). Alteration or diminution in taste perception, which may progress to a total loss of the ability to taste, is encountered in approximately 1 out of 5 patients.…”

Section: Methods Of Administration Side Effects and Toxicitymentioning

confidence: 99%

“…It is manifest first as proteinuria which, if sufficiently severe, may result in develop ment of the nephrotic syndrome (15). T h e mechanism appears to he that of an immune-complex nephritis, with the deposition of y globulin and complement on the glomerular basement membrane and subepithelial deposits in the glomerulus by electron microscopy (13,16). T h e nephropathy has been reversible in these patients after stopping the penicillamine, although u p to 12 months may elapse before the proteinuria completely disappears.…”

Section: Methods Of Administration Side Effects and Toxicitymentioning

confidence: 99%

The treatment of rheumatoid arthritis and necrotizing vasculitis with penicillamine

Jaffe

1970

Arthritis & Rheumatism

Self Cite

131

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“…The possible risk entailed by further administration of D-penicillamine or gold after the appearance of proteinuria during bucillamine therapy must be developed against the ther apeutic effect of the drug in the individual patient [ 11].…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological Findings of Bucillamine-Induced Nephrotic Syndrome in Patients with Rheumatoid Arthritis

Yoshida

Morozumi²,

Suganuma³

et al. 1991

Am J Nephrol

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This paper describes pathological and clinical investigations of glomerular lesions in bucillamine-induced nephropathy by analyzing biopsy materials from 9 patients with rheumatoid arthritis (RA). There was no specific predisposition for nephrotic syndrome induced by bucillamine in clinical profiles related to age, onset, duration of disease, sex, activity and dose of bucillamine. In light-microscopic, electron-microscopic and immunofluorescent findings, the characteristic changes were similar to those of idiopathic membranous glomerulonephritis (MGN). After discontinuance of bucillamine, the nephrotic syndrome improved slowly with or without corticosteroid therapy. Results confirmed that the most common lesion of nephrotic syndrome associated with bucillamine therapy in RA is MGN. We recommend that corticosteroid therapy should be restricted to cases with severe proteinuria.

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Nephropathy Induced by D-Penicillamine

Cited by 82 publications

References 20 publications

Rapidly Progressive Glomerulonephritis in a Patient with Rheumatoid Arthritis during Treatment with High-Dosage <i>D</i>-Penicillamine

Rapidly Progressive Glomerulonephritis in a Patient with Rheumatoid Arthritis during Treatment with High-Dosage <i>D</i>-Penicillamine

The treatment of rheumatoid arthritis and necrotizing vasculitis with penicillamine

Clinicopathological Findings of Bucillamine-Induced Nephrotic Syndrome in Patients with Rheumatoid Arthritis

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