Is D-penicillamine Safe in Management of Little Children with Kidney Cystine Stones? A Case Series
Journal of Pediatric Nephrology,
Vol. 3 No. 4 (2015),
26 September 2015
,
Page 174-177
https://doi.org/10.22037/jpn.v3i4.9099
Abstract
Nephrolithiasis is quite common in children. It sometimes has a genetic basis and can lead to serious complications like urinary obstruction, multiple surgical interventions, or even renal insufficiency if left treated. Cystinic stones and cystinuria account for approximately 8% of the cases of nephrolithiasis in children. We studied seven pediatric patients, 1 to 3 years old (mean age: 20.5 months), with cystinic urinary stones receiving D-penicillamine plus other drugs to dissolve the stone. All of them tolerated the treatment very well and did not show any serious complication. All of our cases were managed with D-penicillamine that was initiated at a low dose and then increased progressively. We used low dose D-penicillamine, maximim15 mg/kg/day, which was beneficial without any specific side effects. D-penicillamine can be used safely in little children. Gradual induction and close observation with CBC, urine analysis, BUN, creatinine, and liver function tests may be required. D-penicillamine can prevent new stone formation and resolve the present cystinic calculi. Low dose D-penicillamine may be sufficient in treating cystinic calculi in children. We suggest more evaluations on the advantage of low dose D-penicillamine in cystinuria.
Keywords: D-Penicillamine; Cystinuria; Nephrolithiasis; Complications
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References
Tasian GE, Copelovitch L. Evaluation and medical management of kidney stones in children. J Urol. 2014 Nov; 192(5):1329-36.
Balestracci A, Battaglia LM, Toledo I, Idiopathic hypercalciuria in children with urinary tract infection. Arch Argent Pediatr. 2014 Oct; 112(5):428-33..
DeBerardinis RJ, Coughlin CR 2nd, Kaplan P. Penicillamine therapy for pediatric cystinuria: experience from a cohort of American children. J Urol. 2008 Dec; 180(6):2620-3.
Aydogdu SD, Kirel B, Coskun T, Kose S. Prevalence of cystinuria among elementary schoolchildren in Eskisehir, Turkey. Scand J Urol Nephrol. 2009; 43(2):138-41.
Halperin EC, Thier SO, Rosenberg LE.The use of D-penicillamine in cystinuria: efficacy and untoward reactions. Yale J Biol Med. 1981 Nov-Dec; 54(6): 439–446.
Seyedzadeh A, Momtaz HE, Moradi MR, Moradi A. Pediatric cystine calculi in west of Iran: a study of 22 cases. Urol J. 2006 Summer;3(3):134-7; discussion 138..
Asanuma H, Nakai H, Takeda M, et al. [Clinical study on cystinuria in children--the stone management and the prevention of calculi recurrence]. Nihon Hinyokika Gakkai Zasshi. 1998 Sep;89(9):758-65..
Tangnararatchakit K, Ariyaprakai W, Tapaneya-Olarn W, et al. Cystinuria: cause of recurrent renal stones in a 4-year-old girl. J Med Assoc Thai. 2002 Nov;85 Suppl 4:S1281-6.
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