Further Observations on Use of D-penicillamine in Cystinuria.
نویسندگان
چکیده
It was shown in a previous communication (Crawhall et al., 1963) that the abnormally high level of cystine excretion found in homozygotes for cystinuria could be reduced for short periods by the administration of D-penicillamine. This paper reports the results of administering the drug continuously to a group of cystinuric patients for periods of five months to one year. We have used the D-isomer of penicillamine rather than the racemic (DL) mixture because L-penicillamine antagonizes pyridoxal phosphate and is known to be toxic in experimental animals (Aposhian and Aposhian, 1959). Continuous treatment with D-penicillamine hasbeen used in other diseases, and no serious toxic effects have been reported. Rash, fever, lymphadenopathy, and leucopenia sometimes occur soon after the beginning of treatment but can be overcome by the administration of anti-inflammatory steroids for short periods (Scheinberg and Sternlieb, 1960). Goldberg et al. (1963) reported proteinuria in a patient with chronic lead-poisoning who was treated with D-penicillamine, and Walshe (1960) observed that a patient who was allergic to penicillin was abnormally sensitive to penicillamine. Levine (1960) noted cutaneous cross-sensitivity reactions to penicillin, benzylpenicilloic acid, and penicillamine. We have previously reported chromatographic evidence for the presence of L-cysteine-D-penicillamine in the urine of cystinuric patients taking D-penicillamine (Crawhall et al., 1963). This substance has now been synthesized and purified. Its solubility properties have been studied, and it has been shown to be identical with the new disulphide which appears in the urine of cystinuric patients taking D-penicillamine.
منابع مشابه
The use of D-penicillamine in cystinuria: efficacy and untoward reactions.
A retrospective study was conducted to assess the efficacy of D-penicillamine in the management of cystinuria, as well as to define the frequency and nature of untoward reactions to this drug. Fifty-six individuals were identified who, by stone analysis and/or biochemical studies, met the accepted diagnostic criteria for phenotypic cystinuria. The majority of these patients presented in the sec...
متن کاملDissolution of bilateral staghorn cystine renal calculi.
Bilateral staghorn renal calculi in a 7-year-old girl with cystinuria were dissolved over a period of 6 months, using a high fluid intake, urinary alkalinisation, and D-penicillamine. Even in children with extensive cystine urolithiasis, medical management may avert the need for surgery.
متن کاملComparative Effect of Silymarin and D-Penicillamine on Lead Induced Hemotoxicity and Oxidative Stress in Rat
Background: This study was performed to investigate the adverse effects of acute lead intoxication on hemogram, erythrocyte osmotic fragility and oxidant/antioxidant status and the probable ameliorating effect of silymarin in comparison to d-penicillamine. Methods: Forty-eight albino rats were divided in 8 groups and received the following treatments in a 10 day experiment in Shahid Chamran ...
متن کاملEvaluation of Oxidative Stress in Combination Therapy with D-penicillamine and N-Acetylcysteine (NAC) in Lead Poisoning in Opium Addicts
Background: N-acetylcysteine (NAC) is a putative antioxidant and has gained attention as a promising agent for chelating heavy metals including lead. Considering the animal studies results, we hypothesized that adding NAC to the treatment regimen may improve the success of treatment with lead chelators. Methods: A total of 46 patients who were lead-poisoned opioid addicts were divided into two ...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- British medical journal
دوره 1 5395 شماره
صفحات -
تاریخ انتشار 1964