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Cholestatic jaundice associated with D-penicillamine therapy
Scandinavian Journal of Rheumatology
|January 1, 1985
Summary
Penicillamine treatment for cystinuria can rarely cause cholestatic jaundice, presenting with fever and rash. Prompt drug discontinuation and corticosteroid therapy aided patient recovery, highlighting a rare adverse effect of penicillamine.
Area of Science:
- Hepatology
- Pharmacology
- Toxicology
Background:
- Penicillamine is a chelating agent used to treat cystinuria and Wilson's disease.
- Drug-induced liver injury (DILI) is a significant concern in clinical practice.
- Cholestatic jaundice is a specific pattern of liver injury characterized by impaired bile flow.
Observation:
- A 35-year-old patient developed fever, rash, and cholestatic jaundice 16 days after starting penicillamine for cystinuria.
- The patient's symptoms indicated a potential adverse reaction to the medication.
- This presentation is a rare but serious complication of penicillamine therapy.
Findings:
- The patient's cholestatic jaundice resolved gradually after discontinuing penicillamine.
- Prolonged treatment with prednisone contributed to the patient's recovery.
- Review of literature confirms penicillamine-induced liver injury as a rare entity.
Implications:
- Clinicians should be vigilant for cholestatic jaundice in patients treated with penicillamine.
- Early recognition and drug withdrawal are crucial for managing penicillamine-induced liver injury.
- This case underscores the importance of monitoring for rare adverse drug reactions.
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