title: [Respiratory complications in the course of treatment with D-penicillamine : alveolitis and bronchiolitis. A report of 4 cases (author's transl)].
abstract: D-penicillamine has proved to be an effective treatment of rheumatoid arthritis, but adverse effects of this drug are frequent. The authors report 4 cases of respiratory disease in the course of treatments with D-penicillamine for which the drug may probably be held responsible. Two patients presented with diffuse alveolitis which improved on stopping D-penicillamine. Two patients presented with rapidly progressive dyspnea; chest X-ray showed distended lungs; lung function tests showed severe airflow obstruction with air trapping : treatment with bronchodilators and corticosteroids was ineffective. Several cases of patients with such features have been reported during the last few years; pathologic studies which were performed disclosed bronchiolitis. Clinicians should be aware of the severity of this type of bronchiolitis and stop D-penicillamine immediately in patients presenting with early respiratory symptoms.
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D001982:Bronchial Diseases / Q000139:chemically induced; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010396:Penicillamine / Q000009:adverse effects*; D011650:Pulmonary Alveoli / Q000503:physiopathology; D011859:Radiography
chemical_list: D010396:Penicillamine
vernacular_title: Accidents respiratoires au cours de traitements par la D-pénicillamine : alvéolites et bronchiolites. Etude de 4 observations.