The relationship between aurothioglucose- and D-penicillamine-induced proteinuria.
We studied patients with rheumatoid arthritis who have been treated with aurothioglucose (Au) and subsequently with D-penicillamine (DP), and who developed drug-induced proteinuria, over a 10-year period. Twelve patients developed Au-induced and 19 DP-induced proteinuria. Of the 12 patients with Au-induced proteinuria, only 2 (17%) developed DP-induced proteinuria, indicating a slightly increased risk as compared with the overall incidence (9.3%) of this reaction in 168 DP-treated patients. In addition, only a minority (2 out of 19, 10.6%) of patients with DP-induced proteinuria had previous Au-induced proteinuria. These data may indicate that different mechanisms are operative in Au and DP-induced proteinuria, as is also suggested by the finding that HLA-DR3 was present more frequently in the latter (50%) than in the former (21%). A history of previous Au-induced proteinuria is insufficient reason to deny these patients the benefits of subsequent treatment with DP.
D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000276:immunology; D006051:Aurothioglucose / Q000009:adverse effects*; D006046:Gold / Q000009:adverse effects*; D006684:HLA-DR Antigens; D000949:Histocompatibility Antigens Class II / Q000032:analysis; D006801:Humans; D010396:Penicillamine / Q000009:adverse effects*; D011507:Proteinuria / Q000139:chemically induced* / Q000276:immunology; D012008:Recurrence
D006684:HLA-DR Antigens; D000949:Histocompatibility Antigens Class II; D006051:Aurothioglucose; D006046:Gold; D010396:Penicillamine