Minimal change nephropathy and pemphigus vulgaris associated with penicillamine treatment of rheumatoid arthritis |
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| Authors: | J S Savill Y Chia C D Pusey |
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| Affiliation: | Department of Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London, England. |
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| Abstract: | A 51-year-old man developed pemphigus vulgaris, minimal change nephropathy and acute tubular necrosis after 11 months of treatment with penicillamine for rheumatoid arthritis associated with features of Reiter's syndrome. Penicillamine is a polyclonal B lymphocyte activator in animals and precipitates a variety of autoimmune reactions in man. The pathogenesis of minimal change nephropathy is obscure, but our observations support the possibility that autoimmune mechanisms play a role. |
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