D-Penicillamine-induced Goodpasture's-like syndrome in primary biliary cirrhosis--successful treatment with plasmapheresis and immunosuppressives.

A 36-yr-old woman with primary biliary cirrhosis developed a Goodpasture's-like syndrome while on D-penicillamine treatment. She responded dramatically to plasmapheresis and immunosuppressive agents. Her illness was felt to be induced by D-penicillamine. This case illustrates the potential toxicity of D-penicillamine in primary biliary cirrhosis. We suggest that this drug be used only in controlled trials until efficacy is demonstrated.