RRML - Nephrotic syndrome after treatment with D-penicillamine in a patient with Wilson’s disease

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Nr. 22(2)/2014 DOI:10.2478/rrlm-2014-0016

Nephrotic syndrome after treatment with D-penicillamine in a patient with Wilson’s disease

Anna D. Kostadinova, Marian Y. Mihaylov, Irena D. Ivanova, Rayna T. Robeva

Abstract:

Wilson’s disease is an inherited autosomal recessive disorder of copper balance leading to accumulation of copper mainly in liver and brain result from absent or reduced function of copper-transporting P-type ATPase. Copper is an essential trace element but in Wilson’s disease it accumulate to the point of toxicity. D-penicillamine is a classic drug for treatment of Wilson’s disease. Its major effect is to promote the urinary copper excretion. The use of D-penicillamine in the therapy of Wilson’s disease is known to be complicated by the development of various glomerular diseases. In this report we describe the development of nephrotic syndrome after 2 years treatment with D-penicillamine in a 31-year-old male undergoing treatment for Wilson’s disease, with a prompt regression at the discontinuation of the drug. We present this case to draw attention to the rare complication as nephrotic syndrome in patients with Wilson’s disease under D-penicillamine treatment and possible underlying causes. It is strongly necessary the therapy and clinical condition of patients with Wilson’s disease to be monitoring regularly – we recommended monthly.

Keywords: Wilson’s disease,D-penicillamine,Urinary copper excretion

Received: 13.09.2013
Accepted: 3.05.2013
Published: 7.05.2014

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Kostadinova AD, Mihaylov MY, Ivanova ID, Robeva RT. Nephrotic syndrome after treatment with D-penicillamine in a patient with Wilson’s disease. Rev Romana Med Lab. 2014;22(2):181-9. DOI:10.2478/rrlm-2014-0016