Diffuse alveolitis as complication of penicillamine treatment for rheumatoid arthritis.

Penicillamine is as effective as gold' when used as an antirheumatic drug.2 Side effects may occur, however, the best recognised being marrow suppression, the nephrotic syndrome, abnormalities of taste, rashes, and gastrointestinal disturbances. All are usually reversible on stopping treatment. Nevertheless, deaths have occurred, and recently three fatal cases of Goodpasture's syndrome were reported in patients taking 1 to 3-5 g penicillamine daily for Wilson's disease over two to three and a half years.3 I report a further pulmonary complication of treatment with penicillamine in a patient given small doses for rheumatoid arthritis.