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The Nephrotic Syndrome as a Complication of Penicillamine Therapy for Hepatolenticular Degeneration (Wilson's Disease)

Ann Intern Med. 1965;62(6):1297-1300. doi:10.7326/0003-4819-62-6-1297
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Since the introduction of penicillamine (β,β dimethylcysteine) as a copper chelating agent by Walshe (1) in 1956, this drug has been used extensively in the therapy of Wilson's disease (2-9) to increase cupruria and diminish body copper deposits. To a large extent penicillamine has replaced dimercaprol (BAL) in the treatment of this disorder, since it can be administered orally. However, allergic reactions to penicillamine are common. These include skin rashes (usually a maculopapular eruption, but at times a nonerythematous desquamation of the skin of the face and trunk), fever, lymphadenopathy, and, rarely, leukopenia and thrombocytopenia (6). Cessation of penicillamine therapy


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