D-penicillamine-induced acute hypersensitivity pneumonitis and cholestatic hepatitis in a patient with rheumatoid arthritis.

Acute hypersensitivity pneumonitis is not a known side effect of D-penicillamine. Also, there are only a few reports of cholestatic hepatitis caused by this drug. The present report describes a case of rheumatoid arthritis where these manifestations appeared in the same patient ten days after the institution of D-penicillamine therapy. The etiological relationship with the drug was established, inadvertantly, by its accidental intake by the patient 5 months later with the reproduction of the same manifestations.