title: D-Penicillamine-induced ANCA-associated crescentic glomerulonephritis in Wilson disease.
abstract: Several drugs, including hydralazine and propylthiouracil, can induce antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis. d-Penicillamine was implicated in a few patients with rheumatoid arthritis or systemic sclerosis, but in patients with both diseases, ANCA-associated vasculitides were described in the absence of the drug. Therefore, the role of d-penicillamine treatment could not be established. We report the first case of antimyeloperoxidase antibody-associated vasculitis in a patient treated with d-penicillamine for Wilson disease. Because Wilson disease was never associated with ANCA-related nephritis, this case strongly supports that d-penicillamine can induce ANCA-vasculitis. The presentation and rapidly progressive and potentially severe outcome of this complication dramatically contrast with those of membranous and minimal change glomerulopathy, also induced by the sulfhydryl compound.
authors.affiliation: Department of Nephrology and Dialysis, Tenon Hospital, APHP, Paris, France.
authors.forename: Frank
authors.initials: F
authors.lastname: Bienaimé
authors.forename: Gaétan
authors.initials: G
authors.lastname: Clerbaux
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Plaisier
authors.forename: Béatrice
authors.initials: B
authors.lastname: Mougenot
authors.forename: Pierre
authors.initials: P
authors.lastname: Ronco
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Rougier
mesh_terms: D000328:Adult; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood*; D002614:Chelating Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003404:Creatinine / Q000097:blood; D018450:Disease Progression; D005260:Female; D005921:Glomerulonephritis / Q000139:chemically induced* / Q000276:immunology / Q000473:pathology; D005938:Glucocorticoids / Q000008:administration & dosage; D006527:Hepatolenticular Degeneration / Q000188:drug therapy*; D006801:Humans; D007677:Kidney Function Tests; D007678:Kidney Glomerulus / Q000473:pathology; D008775:Methylprednisolone / Q000008:administration & dosage; D009336:Necrosis; D010396:Penicillamine / Q000009:adverse effects* / Q000627:therapeutic use; D009195:Peroxidase / Q000276:immunology; D014657:Vasculitis / Q000139:chemically induced* / Q000276:immunology
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic; D002614:Chelating Agents; D005938:Glucocorticoids; D003404:Creatinine; D009195:Peroxidase; D010396:Penicillamine; D008775:Methylprednisolone