D-penicillamine induced crescentic glomerulonephritis: report and review of the literature.
A 56-year-old woman with scleroderma developed rapidly progressive glomerulonephritis with epithelial crescents associated with hemoptysis after 27 months of D-penicillamine therapy and a cumulative dose of 1,200 g. Renal failure necessitated 5 hemodialysis sessions. D-penicillamine was withdrawn and glucocorticoids combined with azathioprine were given with good recovery of renal function. The 9 other reported cases of D-penicillamine induced rapidly progressive glomerulonephritis have been reviewed. This syndrome is potentially life-threatening: the 5 untreated patients died, whereas 5 patients given immunosuppressive therapy are alive.
Rheumatology Unit, Saint-Luc University Hospital, Louvain University in Brussels, Belgium.
J P
JP
Devogelaer
Y
Y
Pirson
J M
JM
Vandenbroucke
J P
JP
Cosyns
S
S
Brichard
C
C
Nagant de Deuxchaisnes
D001706:Biopsy; D005260:Female; D005921:Glomerulonephritis / Q000139:chemically induced* / Q000473:pathology; D006469:Hemoptysis / Q000139:chemically induced; D006801:Humans; D007678:Kidney Glomerulus / Q000473:pathology; D008854:Microscopy, Electron; D008875:Middle Aged; D010396:Penicillamine / Q000009:adverse effects* / Q000627:therapeutic use; D012595:Scleroderma, Systemic / Q000188:drug therapy*
D010396:Penicillamine