title: D-penicillamine toxicity in Greek patients with rheumatoid arthritis: anti-Ro(SSA) antibodies and cryoglobulinemia are predictive factors.
abstract: Sixty-two consecutive patients, with rheumatoid arthritis (RA) who received D-penicillamine were studied retrospectively to identify predictive risk factors for D-penicillamine toxicity. Thirty-two developed side effects, while 30 did not. The clinical picture in both groups was similar, but the group with D-penicillamine toxicity was characterized by a high incidence of anti-Ro(SSA) antibodies (p less than 0.01) or circulating cryoglobulins (p less than 0.001). The presence of anti-Ro(SSA) antibodies was not correlated with the presence of circulating cryoglobulins (p greater than 0.5), while the coefficient of contingency (C) between anti-Ro(SSA) and cryoglobulins was 0.131. Men were predisposed to express more renal pathology (p less than 0.025), while anti-Ro(SSA) positive patients with RA more often expressed rashes (p less than 0.0001) and acute febrile reactions (p less than 0.05) than anti-Ro(SSA) negative patients. These observations should be considered when making therapeutic decisions at least for Greek patients with RA.
authors.affiliation: Department of Internal Medicine, School of Medicine, University of Ioannina, Greece.
authors.forename: P G
authors.initials: PG
authors.lastname: Vlachoyiannopoulos
authors.forename: L V
authors.initials: LV
authors.lastname: Zerva
authors.forename: F N
authors.initials: FN
authors.lastname: Skopouli
authors.forename: A A
authors.initials: AA
authors.lastname: Drosos
authors.forename: H M
authors.initials: HM
authors.lastname: Moutsopoulos
mesh_terms: D000974:Antibodies, Antinuclear / Q000032:analysis*; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy* / Q000208:ethnology / Q000276:immunology; D003449:Cryoglobulinemia / Q000150:complications*; D003875:Drug Eruptions; D005260:Female; D005455:Fluorescent Antibody Technique; D005544:Forecasting; D006115:Greece / Q000208:ethnology; D006801:Humans; D008297:Male; D010396:Penicillamine / Q000009:adverse effects*
chemical_list: D000974:Antibodies, Antinuclear; C035356:SS-A antibodies; D010396:Penicillamine