Author(s): Bienaim F, Clerbaux G, Plaisier E, Mougenot B, Ronco P,
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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.
This article was published in Am J Kidney Dis
and referenced in Journal of Nephrology & Therapeutics