D-penicillamine-induced bronchial spasm

Although d-penicillamine has a wide range of benefits in many clinical conditions, various side effects have also been reported and preclude its further use in certain patients. In this case, d-penicillamine-induced reversible airway obstruction developed, despite the "go slow--go low" regimen as suggested to reduce the incidence of its side effects. The patient had bronchial spasm and angioedema shortly after the dose was increased from 500 mg to 750 mg/day. Persistent vigilance is necessary to avoid potentially fatal reactions.