Skip to main content
SpringerLink
Log in

Side-effects of penicillamine: some recent aspects

  • Chapter
Side-Effects of Anti-Inflammatory Drugs

Part of the book series: Inflammation and Drug Therapy Series ((IDTH,volume 2))

Abstract

Reports of adverse reactions to penicillamine multiplied in the years immediately after it began to be widely prescribed as an antirheumatoid treatment. Although penicillamine had for a decade earlier been the standard (because the only effective) treatment for hepatolenticular degeneration (Wilson’s disease), it was not regarded as highly toxic, though it was known to give rise to sensitivity rashes early in treatment, drug lupus, glomerulonephritis and, after several years of treatment, certain lesions of the skin that were attributed to a direct effect on dermal collagen. Most patients affected by these disturbances continued the treatment despite them.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. O’Brien, WM (1980). Toxicity of D-penicillamine in rheumatoid arthritis. Ann Intern Med, 92, 120

    PubMed  Google Scholar 

  2. Scott, DL (1984). Penicillamine. In: Goddard, D and Butler, R (eds), Rheumatoid Arthritis: The Treatment Controversy. ( London: Macmillan ), p. 37

    Google Scholar 

  3. Jaffe, IA (1981). Induction of auto-immune syndromes by penicillamine therapy in rheumatoid arthritis and other diseases. Springer Semin Immunopathol, 4, 193

    Article  PubMed  CAS  Google Scholar 

  4. Lyle, WH (1982). Influence of underlying disease on D-penicillamine induced side effects. In: Dawkins, RL, Christiansen, FT and Zilko, PJ (eds), Immunogenetics in Rheumatology: Musculoskeletal Disease and D-penicillamine, p. 306. ( Amsterdam: Excerpta Medica )

    Google Scholar 

  5. Storch, W, Lössner, J and Ruchholtz, U (1979). Schwerwiegende Nebenwirkun-gen unter D-penicillamintherapie der Wilsonschen Erkrankung. Phychiat Neurol Med Psychol Leipzig, 31, 531

    CAS  Google Scholar 

  6. Halperin, EC, Thier, SO and Rosenberg, LE (1981). The use of D- penicillamine in cystinuria: Efficacy and untoward reactions. Yale J Biol Med, 54, 439

    Google Scholar 

  7. Halverson, PB, Kozin, F, Gerson, CB and Goldman, AL (1978). Toxicity of penicillamine: A serious limitation to therapy in rheumatoid arthritis. J Am Med Assoc, 240, 1870

    Google Scholar 

  8. Dixon, A St J, Davies, J, Dormandy, TL, Hamilton, EBD, Holt, PJL, Mason, RM, Thompson, M, Weber, JCP and Zutshi, DW (1975). Synthetic D(-)penicillamine in rheumatoid arthritis. Double-blind controlled study of a high and low dosage regimen. Ann Rheum Dis, 34, 416

    Google Scholar 

  9. Golding, JR, Hickling, P, Martin, MFR, Davidson, AM, Simpson, NC, Brown, RM, Day, AT, Langstaff, SR and Burton, KB (1981). Low dose penicillamine in rheumatoid arthritis: seven years’ experience - a preliminary report. In: Maini, RN and Berry, H (eds), Modulation of Autoimmunity and Disease: The Penicillamine Experience. ( Eastbourne: Praeger ), p. 173

    Google Scholar 

  10. Lyle, WH (1984). Clinical response in relation to dose of penicillamine in the treatment of rheumatoid arthritis. Int J Clin Pharmacol Res, IV, 403

    Google Scholar 

  11. Grindulis, KA and McConkey, B (1984). Outcome of attempts to treat rheumatoid arthritis with gold, penicillamine, sulphasalazine, or dapsone. Ann Rheum Dis, 43, 398

    Article  PubMed  CAS  Google Scholar 

  12. Perrett, D (1981). The metabolism and pharmacology of D-penicillamine in man. J Rheumatol, 8 (Suppl. 7), 41

    Google Scholar 

  13. Muijsers, A0, Stadt, RJ van de, Henrichs, AMA, Ament, HJW and Korst, JK van der (1984). D-penicillamine in patients with rheumatoid arthritis. Serum levels, pharmacokinetic aspects and correlation with clinical course and side effects. Arth Rheum, 27, 1362

    Google Scholar 

  14. Brooks, PM, Miners, JO, Smith, K, Smith MD, Fearnley, I and Birkett, DJ (1984). Dose, plasma concentration and response relationships of Dpenicillamine in patients with rheumatoid arthritis. J Rheumatol, 11, 772

    PubMed  CAS  Google Scholar 

  15. Solomon, L, Abrams, G, Dinner, M and Berman, L (1977). Neonatal abnormalities associated with D-penicillamine treatment during pregnancy. N Engl J Med, 296, 54

    Article  PubMed  CAS  Google Scholar 

  16. Wilkinson, ML, Portmann, B and Williams, R (1983). Wilson’s Disease and hepatocellular carcinoma: possible protective role of copper. Gut, 24, 767

    Article  PubMed  CAS  Google Scholar 

  17. Guan, R, Oon, CJ, Wong, PK, Foong, WC and Wee, A (1985). Primary hepatocellular carcinoma associated with Wilson’s disease in a young woman. Postgrad Med J, 61, 357

    Article  PubMed  CAS  Google Scholar 

  18. Takeda, T, Yao, C-S, Irimo, M, Tashiro, S-I and Yasuhira, K (1980). Dpenicillamine toxicity in mice I. pathological findings. Toxicol Appl Pharmacol, 55, 324

    Article  PubMed  CAS  Google Scholar 

  19. Rumsby, PC and Shepherd, DM (1981). The effect of penicillamine on vitamin B6 function in man. Biochem Pharmacol, 30, 3051

    Article  PubMed  CAS  Google Scholar 

  20. Nimni, ME (1977). Mechanism of inhibition of collagen cross-linking by penicillamine. Proc R Soc Med, 70 (Suppl. 3), 65

    PubMed  CAS  Google Scholar 

  21. Williams, EC, Janmey, PA, Johnson, RB and Mosher, DF (1983). Fibronectin: effect of disulfide bond reduction on its physical and functional properties. J Biol Chem, 258, 5911

    PubMed  CAS  Google Scholar 

  22. Emery, P, Panayi, GS, Huston, G, Welsh, KI, Mitchell, SC, Shah, RR, Idle, JR, Smith, RL and Waring, RH (1984). D-penicillamine induced toxicity in rheumatoid arthritis: the role of sulphoxidation status and HLA-DR3. J Rheumatol, 11, 626

    PubMed  CAS  Google Scholar 

  23. Thomas, RHM, Light, N, Stephens, AD, Avery, NC and Kirby, JDT (1984). Pseudoxanthoma elasticum-like skin changes induced by penicillamine. J R Soc Med, 77, 794

    Google Scholar 

  24. Hashimoto, K, McEvoy, B and Belcher, R (1981). Ultrastructure of penicillamine-induced skin lesions. J Am Acad Dermatol, 4, 300

    Article  PubMed  CAS  Google Scholar 

  25. Corke, CF, Meyrick, TR, Huskisson, EC and Kirby, JD, (1983). Pityriasis rosea-like rashes complicating drug therapy for rheumatoid arthritis. Br J Rheumatol, 22, 187

    Article  PubMed  CAS  Google Scholar 

  26. Seehafer, JR, Rogers, RS, Fleming, CR and Dickson, ER (1981). Lichen planus-like lesions caused by penicillamine in primary biliary cirrhosis. Arch Dermatol, 117, 140

    Article  PubMed  CAS  Google Scholar 

  27. Blasberg, B, Dorey, JL, Stein, HB, Chalmers, A and Conklin, RJ (1984). Lichenoid lesions of the oral mucosa in rheumatoid arthritis patients treated with penicillamine. J Rheumatol, 11, 348

    PubMed  CAS  Google Scholar 

  28. Marsden, RA, Dawber, RPR, Millard, PR and Mowat, AG (1977). Herpetiform pemphigus induced by penicillamine. Br J Dermatol, 97, 451

    Article  PubMed  CAS  Google Scholar 

  29. Troy, JL, Silvers, DN, Grossman, ME and Jaffe, IA (1981). Penicillamineassociated pemphigus: is it really pemphigus? J Am Acad Dermatol, 4, 547

    Article  PubMed  CAS  Google Scholar 

  30. Yung, CW and Hambrick, GW (1982). D-penicillamine-induced pemphigus syndrome. J Am Acad Dermatol, 6, 317

    Article  PubMed  CAS  Google Scholar 

  31. Zone, J, Ward, J, Boyce, E and Schupbach, C (1982). Penicillamine-induced pemphigus. J Am Med Assoc, 247, 2705

    Article  CAS  Google Scholar 

  32. Ruocco, V, de Angelis, E, de Luca, M, Pisani, M and Prota, G (1983). Specific incorporation of penicillamine into the epidermis of mice: an autoradiographic study. Br J Dermatol, 108, 441

    Article  PubMed  CAS  Google Scholar 

  33. Ruocco, V, de Luca, M, Pisani, M, de Angelis, E, Vitale, 0 and Astarita, C (1982). Pemphigus provoked by D(-) penicillamine: an experimental approach using in vitro tissue cultures. Dermatologica, 164, 236

    CAS  Google Scholar 

  34. Hashimoto, K, Singer, K and Lazarus, GS (1984). Penicillamine-induced pemphigus. Immunoglobulin from this patient induces plasminogen activator synthesis by human epidermal cells in culture: mechanism for acantholysis in pemphigus. Arch Dermatol, 120, 762

    Article  PubMed  CAS  Google Scholar 

  35. Kirby, JD, Dieppe, PA, Huskisson, EC and Smith, B (1979). D-penicillamine and immune complex deposition. Ann Rheum Dis, 38, 344

    Article  PubMed  CAS  Google Scholar 

  36. F$rre, 0, Munthe, E and Kass, E (1984). Side-effects and autoimmunogenicity of D-penicillamine treatment in rheumatic diseases. In Rainsford, KD and Velo, G (eds), Side-effects of Anti-inflammatory/Analgesic Drugs. ( New York: Raven Press ), p. 251

    Google Scholar 

  37. Hall, CL (1982). Gold and D-penicillamine induced renal disease. In: Bacon, PA and Hadler, NM (eds), The Kidney and Rheumatic Disease. ( London: Butterworth ), p. 246

    Google Scholar 

  38. Bourke, BE, Woodrow, DF and Scott, JT (1981). Proteinuria in rheumatoid arthritis - drug-induced or amyloid? Ann Rheum Dis, 40, 240

    Article  PubMed  CAS  Google Scholar 

  39. Latta, H (1980). Filtration barrier in the glomerular capillary wall. In: Maunsbach, AB, Olsen, JS and Christensen, EI (eds), Functional Ultrastructure of the Kidney. ( London: Academic Press ), p. 3

    Google Scholar 

  40. Nienhuis, RLF (1981). A double-blind clinical trial with D-penicillamine in patients with rheumatoid arthritis. Acta Therap, 7, 323

    Google Scholar 

  41. Willoughby, JMT (1980). Drug-induced abnormalities of taste sensation. Adv Drug Reaction Bull, 100, 368

    Article  Google Scholar 

  42. Ciges, M and Morales, J (1980). Experimental ageusia. Acta Otolaryngol, 89, 240

    Article  PubMed  CAS  Google Scholar 

  43. Bever, CT, Chang, HW, Penn, AG, Jaffe, IA and Bock, E (1982). Penicillamine-induced myasthenia gravis: effects of penicillamine on acetylcholine receptor. Neurology, 32, 1077

    PubMed  CAS  Google Scholar 

  44. Marcus, SN, Chadwick, D and Walker, RJ (1984). D-penicillamine-induced myasthenia gravis in primary biliary cirrhosis. Gastroenterology, 86, 166

    PubMed  CAS  Google Scholar 

  45. Sundstrom, WR and Schuna, AA (1979). Penicillamine-induced myasthenia gravis. Arthr Rheum, 22, 197

    Article  CAS  Google Scholar 

  46. Bégin, R, Massé, S, Cantin, A, Ménard, H and Bureau, M (1982). Airway disease in a subset of non-smoking rheumatoid patients. Characterisation of the disease and evidence for an autoimmune pathogenesis. Am J Med, 72, 743

    Google Scholar 

  47. Penny, WJ, Knight, RK, Rees, AM, Thomas, AL and Smith, AP (1982). Obliterative bronchiolitis in rheumatoid arthritis. Ann Rheum Dis, 41, 469

    Article  PubMed  CAS  Google Scholar 

  48. Pieters, R, Martens, J and Dequeker, J (1982). Rheumatoid arthritis as-sociated with bronchiolitis obliterans and immunoblastic sarcoma. Clin Rheumatol, 1, 35

    Article  PubMed  CAS  Google Scholar 

  49. Snaith, ML (1970). Sjögren’s syndrome and D-penicillamine. In: Maini, RN and Berry, H (eds), Modulation of Autoimmunity and Disease. ( New York: Praeger ), p. 70

    Google Scholar 

  50. Moutsopoulos, HM, Skopouli, FN, Sarras, AK, Tsampoulas, C, Mavridis, AK, Constantopoulos, SH and Maddison, PJ (1985). Anti-Ro(SSA) positive rheumatoid arthritis (RA): a clinicoserological group of patients with high incidence of D-penicillamine side effects. Ann Rheum Dis, 44, 215

    Article  PubMed  CAS  Google Scholar 

  51. Olomu, A, Clements, D, Waring, R and Elias, E (1985). Poor sulphoxidation in primary biliary cirrhosis. Lancet, 1, 1504

    Article  PubMed  CAS  Google Scholar 

  52. Thomas, D, Gallus, AS, Brooks, PM, Tampi, R, Geddes, R and Hill, W (1984). Thrombokinetics in patients with rheumatoid arthritis treated with Dpenicillamine. Ann Rheum Dis, 43, 402

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Courtaulds plc Medical Department, 18 Hanover Square, London, UK

    W. H. Lyle

Authors
  1. W. H. Lyle
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Pharmacology, University of Cambridge, and Strangeways Research Laboratory, Hills Road, CB2 2QD, Cambridge, UK

    K. D. Rainsford

  2. Institute of Pharmacology, University of Verona, Verona, Italy

    G. P. Velo

Rights and permissions

Reprints and permissions

Copyright information

© 1987 MTP Press Limited

About this chapter

Cite this chapter

Lyle, W.H. (1987). Side-effects of penicillamine: some recent aspects. In: Rainsford, K.D., Velo, G.P. (eds) Side-Effects of Anti-Inflammatory Drugs. Inflammation and Drug Therapy Series, vol 2. Springer, Dordrecht. https://doi.org/10.1007/978-94-010-9775-8_20

Download citation

  • DOI: https://doi.org/10.1007/978-94-010-9775-8_20

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-010-9777-2

  • Online ISBN: 978-94-010-9775-8

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation