Adverse reactions affecting the lung: possible association with D-penicillamine

Pulmonary hemorrhage and progressive renal failure in D-penicillamine-treated patients occurs rarely and does not fulfil the commonly used current criteria for Goodpasture's syndrome. Evidence suggests that the condition may develop as a result of drug-induced immune complex deposition. Histological and immunological information is too scanty to be certain whether pulmonary infiltrates occur in the absence of hemorrhage or whether they represent capillary damage of the same immunopathogenesis but of a milder form. Obliterative broncho-bronchiolitis has been seen in some patients who have never received penicillamine so that a cause and effect relationship has not been established.