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D-penicillamine-induced lupus erythematosus
R J Enzenauer1, S G West, R L Rubin
1Rheumatology Service, Fitzsimons Army Medical Center, Aurora, Colorado 80045.
Arthritis and Rheumatism
|October 1, 1990
Summary
D-penicillamine therapy can induce antinuclear antibodies, causing symptoms like polyarthritis and pleurisy. Stopping the drug led to symptom and antibody resolution in a patient.
Area of Science:
- Rheumatology
- Immunology
- Pharmacology
Background:
- D-penicillamine is a chelating agent used to treat Wilson's disease and rheumatoid arthritis.
- Drug-induced autoimmunity is a known complication of various medications.
Observation:
- A patient developed polyarthritis, pleurisy, rash, and positive antinuclear antibodies (ANA) after five years of D-penicillamine treatment.
- The patient's ANA were predominantly high-titer IgG against the (H2A-H2B)-DNA complex, with some IgM activity against H1 and H2B.
Findings:
- D-penicillamine therapy was associated with the development of specific antinuclear antibodies.
- Discontinuation of D-penicillamine resulted in clinical improvement and serological normalization.
Implications:
- This case highlights D-penicillamine as a potential cause of drug-induced lupus-like syndrome.
- Understanding the specific antibody targets can aid in diagnosing and managing drug-induced autoimmunity.