title: Extracapillary glomerulonephritis with necrotizing vasculitis in D-penicillamine-treated rheumatoid arthritis.
abstract: Rapidly progressive glomerulonephritis occurred in a woman with rheumatoid arthritis (RA) who had been treated with D-penicillamine for 3 months. Light microscopy study of the kidney showed severe glomerulonephritis with crescent formation in 50% of glomeruli and necrotizing vasculitis. Immunoflurescence revealed IgA and C3 granular deposits diffusely distributed along the capillary walls. The patient was treated with steroid 'pulse', antiplatelet agents and heparin and a partial recovery of renal function was observed after 2 months of anuria. This renal picture is unlike that reported in RA and a causative role for D-penicillamine is suggested.
mesh_terms: D001172:Arthritis, Rheumatoid / Q000150:complications*; D005260:Female; D005455:Fluorescent Antibody Technique; D005921:Glomerulonephritis / Q000139:chemically induced* / Q000473:pathology; D006801:Humans; D008854:Microscopy, Electron; D008875:Middle Aged; D010396:Penicillamine / Q000009:adverse effects*; D014657:Vasculitis / Q000139:chemically induced / Q000473:pathology
chemical_list: D010396:Penicillamine