[Morphology and pathogenesis of penicillamine-induced nephropathy]

Histological, immunohistological and electron microscopical investigations on the glomerular renal lesions in penicillamine-induced nephropathy were carried out by studying biopsy material of eight patients with rheumatoid arthritis (4 cases), allergic alveolitis (3 cases) and systemic scleroderma (1 case) under the treatment with D-penicillamine. Summarizing all the findings, the characteristic pattern of immune complex nephritis as membranous type glomerulonephritis on the one hand and proliferative type glomerulonephritis (mesangioproliferative GN, focal proliferative GN or minimal proliferative GN) on the other hand could be demonstrated. The different types of glomerular alterations in penicillamine nephropathy obviously depend on the kind and duration of the primary main disease and on the individual immune reactivity of the body was a whole by this determined. The possible pathogenesis related to definite effects of the D-penicillamine is discussed and compared with the communications in the literature.