Falck H M, Törnroth T, Kock B, Wegelius O
Acta Med Scand. 1979;205(1-2):133-8. doi: 10.1111/j.0954-6820.1979.tb06018.x.
Two cases with different and not previously described fatal renal complications during treatment with penicillamine are reported. A man with seronegative rheumatoid arthritis with features of systemic lupus erythematosus was treated with penicillamine for six months and developed a mild membranous glomerulonephritis and a severe renal vasculitis leading to uremia and death. A woman with primary biliary cirrhosis was treated with penicillamine for nine months and developed a nephrotic syndrome, the renal biopsy showing minimal change glomerulonephritis. The nephrotic syndrome responded to prednisone but the patient died, probably from septicemia. Penicillamine may thus cause glomerular damage without deposition of immune complexes. A restricted use of the drug is recommended.
报告了两例在用青霉胺治疗期间出现不同且先前未描述过的致命性肾脏并发症的病例。一名患有血清阴性类风湿关节炎且具有系统性红斑狼疮特征的男性接受了六个月的青霉胺治疗，出现了轻度膜性肾小球肾炎和严重的肾血管炎，导致尿毒症和死亡。一名原发性胆汁性肝硬化女性接受了九个月的青霉胺治疗，出现了肾病综合征，肾脏活检显示为微小病变性肾小球肾炎。肾病综合征对泼尼松有反应，但患者可能因败血症死亡。因此，青霉胺可能导致肾小球损伤而无免疫复合物沉积。建议限制使用该药物。
