Skin and bone lesions (dermato-osteolathyrism), possible side effects of D-penicillamine treatment, in a boy with cystinuria

Helv Paediatr Acta. 1979;34(3):281-91.

Abstract

A 2 1/4 year-old boy was treated for cystinuria and urolithiasis with high fluid intake, sodium bicarbonate, and D-penicillamine, over a period of 5 3/4 years, unauthorized interruptions and prescribed pauses included. Therapy was partially sucessful but regrowth of calculi coincided with interruptions of D-penicillamine administration and also with the institution of a low-dose D-penicillamine regime. Flat feet, scoliosis, pectus carinatum, hypermobility of joints, molluscoid pseudotumors and atrophic scars were alarming side effects of D-penicillamine. However, the possibility was not excluded that a forme fruste of an Ehlers-Danlos syndrome preexisted in this boy and was effected by D-penicillamine. Only the molluscoid pseudotumors regressed when D-penicillamine was reduced or omitted temporarily. Osteolathyrism caused by D-penicillamine has hitherto not been reported in man.

Publication types

  • Case Reports

MeSH terms

  • Atrophy
  • Bicarbonates / therapeutic use
  • Bone Diseases / chemically induced*
  • Bone and Bones / drug effects
  • Child, Preschool
  • Cystinuria / drug therapy*
  • Drug Eruptions
  • Ehlers-Danlos Syndrome
  • Flatfoot / chemically induced
  • Humans
  • Joint Diseases / chemically induced
  • Kidney Calculi / drug therapy*
  • Lathyrism / chemically induced*
  • Male
  • Penicillamine / adverse effects*
  • Penicillamine / therapeutic use
  • Recurrence
  • Scoliosis / chemically induced
  • Skin / drug effects
  • Skin / pathology
  • Skin Diseases / chemically induced*
  • Urinary Bladder Calculi / drug therapy*

Substances

  • Bicarbonates
  • Penicillamine