[Lupus biology: incidence and development in 84 rheumatoid polyarthritis patients treated with D-penicillamine]

Eighty four patients with classical rheumatoid arthritis were treated with 300-1 200 mg/day of D-Penicillamine. During follow-up, attention was paid to various clinical and biological parameters including the antinuclear factor (ANF) and anti-deoxyribonucleic acid (DNA) antibodies. Before therapy the ANF was greater than or equal to 1/50 in 22 patients (26 p. 100); it increased significantly in treated patients (p less than or equal to 0.01). In addition, positive ANF were found in 22 of the 62 patients (35.5 p. 100) who had negative ANF before D-Penicillamine therapy. There was no correlation between the appearance of ANF or the increase in ANF levels and the initial clinical and biological status, tolerance of therapy, the percentage of cases in which D-Penicillamine was effective. Anti-DNA antibodies were found in 5 patients but no clinical signs of lupus disease were observed despite treatment periods of up to 3.5 years in one case. Anti-SM antibodies were also found in one female patient. The disappearance of anti-DNA antibodies after reducing the dosage of D-Penicillamine (1 case) or withdrawal of therapy (2 cases) is an argument in favour of the inducing role of the drug. The incidence, signification and consequences of these observations are analysed and compared with previously reported results.