Nephrotic syndrome induced by D-penicillamine therapy

Area of Science:

• Nephrology
• Pharmacology

Background:

• Penicillamine is a chelating agent used to treat conditions like Wilson's disease and cystinuria.
• Aggressive hepatitis requires potent therapeutic interventions, sometimes including penicillamine.

Observation:

• A female patient developed nephrotic syndrome during penicillamine treatment for aggressive hepatitis.
• Renal biopsy confirmed membranous glomerulonephritis as the cause of nephrotic syndrome.

Findings:

• Penicillamine therapy was identified as the trigger for drug-induced nephrotic syndrome.
• Cessation of penicillamine resulted in normalization of renal function and laboratory parameters.

Implications:

• This case highlights a rare but serious adverse effect of penicillamine, emphasizing the need for careful patient monitoring.
• The findings support the judicious use of penicillamine, reserving it for specific indications where benefits outweigh risks, such as Wilson's disease and cystinuria.