D-penicillamine-induced crescentic glomerulonephritis and antimyeloperoxidase antibodies in a patient with scleroderma - Case report and review of the literature

被引:24
|
作者
Karpinski, J
Jothy, S
Radoux, V
Levy, M
Baran, D
机构
[1] ROYAL VICTORIA HOSP,DIV NEPHROL,MONTREAL,PQ H3A 1A1,CANADA
[2] ROYAL VICTORIA HOSP,DEPT PATHOL,MONTREAL,PQ H3A 1A1,CANADA
[3] MCGILL UNIV,MONTREAL,PQ,CANADA
[4] HOP HOTEL DIEU,DIV RHEUMATOL,MONTREAL,PQ H2W 1T8,CANADA
关键词
D-penicillamine; scleroderma; drug side effects; glomerulonephritis; anti-myeloperoxidase antibodies; treatment; prognosis;
D O I
10.1159/000169183
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Therapeutic use of D-penicillamine has been associated with a range of adverse effects. We present a patient with scleroderma, treated with D-penicillamine for 5 years, who developed severe renal failure due to rapidly progressive glomerulonephritis with both crescents and subepithelial immune deposits on renal biopsy. Serological findings included perinuclear antineutrophil cytoplasmic antibodies and antihistone antibodies. She was treated with cyclophosphamide, prednisone, discontinuation of D-penicillamine, and hemodialysis. Therapy resulted in partial recovery of renal function, The clinical course of our patient is in keeping with D-penicillamine-induced chronic membranous nephropathy, followed by rapidly progressive crescentic glomerulonephritis, We discuss the effects of D-penicillamine in our patient, and review the literature on immune-mediated renal disease associated with the use of this drug.
引用
收藏
页码:528 / 532
页数:5
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