Crawhall J C
J Rheumatol Suppl. 1981 Jan-Feb;7:161-3.
The incidence of proteinuria in D-penicillamine-treated rheumatoid arthritis has been between 10% and 20% in the 1st year of therapy; afterward, few develop proteinuria. Incidence is related to both quantity of penicillamine administered and inherent response variability. About 1/3 of those with proteinuria may proceed to a nephrotic syndrome if therapy is continued. Light microscopy of renal biopsy tissue shows only minimal glomerular changes. Electron microscopy reveals sub-epithelial electron-dense deposits and fusion of epithelial cell processes. Immunofluorescence microscopy demonstrates granular capillary wall deposits of IgG and C3.
在接受青霉胺治疗的类风湿性关节炎患者中，蛋白尿的发生率在治疗的第1年为10%至20%；此后，很少有人会出现蛋白尿。发生率与所给予的青霉胺剂量以及个体反应差异均有关。如果继续治疗，约1/3的蛋白尿患者可能会发展为肾病综合征。肾活检组织的光镜检查仅显示肾小球有轻微变化。电镜检查发现上皮下电子致密沉积物以及上皮细胞突起融合。免疫荧光显微镜检查显示IgG和C3在毛细血管壁呈颗粒状沉积。
