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Reduction of Cystine Crystalluria With Chlordiazepoxide and During Nephrotic Syndrome

Bruce L. Fariss, MD; Felix O. Kolb, MD

JAMA. 1968;205(12):846-848.

Abstract
Six patients with persistent cystine crystalluria were given chlordiazepoxide hydrochloride (Librium) in a daily dose of 5 to 40 mg by mouth. While taking this drug, the patients had a prompt reduction in cystine crystalluria. When administration of the medication was stopped, cystine crystals were again noted but disappeared when the patients again began taking chlordiazepoxide. No other medications were prescribed during this study, and no attempt was made to control food or fluid intake. Also, a patient with cystine crystalluria was observed to have a decrease of cystine crystals in his urine with the development of the nephrotic syndrome during treatment with penicillamine (D-penicillamine). On reduction of his proteinuria, there was a prompt return of cystine crystals without a significant change in total cystine excretion. Possible mechanisms to explain these observations are under investigation.

Author Affiliations
From the Metabolic Research Unit and Department of Medicine, University of Calfiornia Medical Center, San Francisco.

Footnotes
Reprint requests to Metabolic Research Unit, University of California Medical Center, San Francisco 94122 (Dr. Kolb).

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