Cordier J F, Moulin J, Brune J, Moulin G, Touraine R
Rev Fr Mal Respir. 1981;9(4):319-26.
D-penicillamine has proved to be an effective treatment of rheumatoid arthritis, but adverse effects of this drug are frequent. The authors report 4 cases of respiratory disease in the course of treatments with D-penicillamine for which the drug may probably be held responsible. Two patients presented with diffuse alveolitis which improved on stopping D-penicillamine. Two patients presented with rapidly progressive dyspnea; chest X-ray showed distended lungs; lung function tests showed severe airflow obstruction with air trapping : treatment with bronchodilators and corticosteroids was ineffective. Several cases of patients with such features have been reported during the last few years; pathologic studies which were performed disclosed bronchiolitis. Clinicians should be aware of the severity of this type of bronchiolitis and stop D-penicillamine immediately in patients presenting with early respiratory symptoms.
D-青霉胺已被证明是治疗类风湿性关节炎的一种有效药物，但该药的不良反应很常见。作者报告了4例在使用D-青霉胺治疗过程中出现的呼吸系统疾病，该药可能是其病因。两名患者出现弥漫性肺泡炎，停用D-青霉胺后病情好转。两名患者出现快速进行性呼吸困难；胸部X光显示肺部膨胀；肺功能测试显示严重的气流阻塞并伴有气体潴留：使用支气管扩张剂和皮质类固醇治疗无效。在过去几年中已经报道了几例具有此类特征的患者；所进行的病理研究显示为细支气管炎。临床医生应意识到这种类型细支气管炎的严重性，并在出现早期呼吸道症状的患者中立即停用D-青霉胺。
