Nephrotic Syndrome after Treatment with D-Penicillamine in a Patient with Wilson’s Disease- A Case Report
Journal of Pediatric Nephrology,
Vol. 4 No. 2 (2016),
4 July 2016
,
Page 70-73
https://doi.org/10.22037/jpn.v4i2.11602
Abstract
We report a case with Wilson’s disease who developed nephrotic syndrome one year after starting D-pencillamine. After stopping D-penicillamine, only zinc was given for maintenance. His proteinuria resolved after four weeks of full dose prednisolone administration and three intravenous methylprednosolone injections for nephrotic syndrome. Membranous glomerulopathy is most commonly associated with nephrotic syndrome secondary to D penicillamine but isolated cases of minimal change lesions are also reported like our case.
The most likely cause of nephrotic syndrome in this child was the late complications of D-penicillamine. It also reemphasizes the importance of early monitoring for proteinuria and the need to shift to an alternative agent if side effects develop.
Keywords: Nephrotic syndrome; D-pencillamine; Wilson’s disease.- Nephrotic syndrome
- D-pencillamine
- Wilson’s disease.
How to Cite
References
Gordillo R, Spitzer A. The Nephrotic Syndrome. Pediatrics in Review 2009;30(3):94-104.
Rahman MH, Jesmin T, Muinuddin G. An Update of Management of Idiopathic Nephrotic Syndrome:A Review Article. Bangladesh J Child Health 2013; 37(2): 102-121.
Pais P, Avner ED. Nephrotic Syndrome. In: Kliegman RM, Stanton BF, Geme JWS, Schor NF (editors). Nelson Textbook of Pediatrics. 20th edition.Philadelphia:Elsevier;2016:2521-22.
Scheinberg IH, Sternlieb I. Wilson’s disease. In: Smith LH, ed. Major problems in internal medicine, vol 23.Philadelphia: WB Saunders,1984:134–49.
Halverson PB, Kozin F, Bernhard GC, Goldman AL.Toxicity of penicillamine. A serious limitation to therapy in rheumatoid arthritis. JAMA 1978; 240:1870 –71.
Taylor HG, Samanta A. Penicillamine in rheumatoid arthritis. A problem of toxicity. Drug Safety 1992;7:46–53.
Hall CL. The natural course of gold and penicillamine nephropathy: A long term study of 54 patients. Adv Exp Med Biol 1989;253:247–56.
William F, Balistreri, Rebecca G, Carey. Wilson Disease.In Kliegman RM, Stanton BF, Geme JWS, Schor NF (editors). Nelson Textbook of Pediatrics. 20th edition.Philadelphia: Elsevier;2016:1939-40.
Fernandes L, Swinson DR, Hamilton EB. Dermatomyositis Complicating Penicillamine Treatment. Annals of the Rheumatic Diseases 1977;36:94-95
Lund HI, Nielsen M. Penicillamine Induced Dermatomyositis, A Case History. Scandinavian Journal of Rheumatology 1983;12(4):350-352.
Roberts E, Schilsky M. Diagnosis and treatment of Wilson disease: An update. Aasld Practice Guideline. Hepatology 2008;47:2089-2111.
Bell CL, Graziano RM. The safety of administration of penicillamine to penicillin-sensitive individuals. Arch Rheum 1983;26:801– 803.
Walshe M. Wilson’s disease presenting wth features of hepatic dysfunction: A clinical analysis of eighty seven patients. Q J Med 1989;263:253-63.
Habib GS, Saliba W, Nashashibi M, Armali Z. Penicillamine and nephritic syndrome. European Journal of Internal Medicine 2006;17;343-348.
Beacon PA, Tribe CR, Mackenzie JC, et al. Penicillamine nephropathy in rheumatoid arthritis. Q J Med 1976;45:661– 84.
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