This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

A Possible Relationship to the Use of Penicillamine

Gary R. Epler, MD; Gordon L. Snider, MD; Edward A. Gaensler, MD; Edgar S. Cathcart, MD; Muiris X. FitzGerald, MD; Charles B. Carrington, MD

JAMA. 1979;242(6):528-532.

Abstract
Rapid onset of severe and irreversible airflow obstruction developed in two women. One had eosinophilic fasciitis and the other had rheumatoid arthritis. Both were treated with penicillamine. In the first patient, aged 42 years, dyspnea developed after six months of therapy. Her roentgenogram showed hyperinflation. Forced vital capacity expired in one second (FEV₁/FVC%) decreased from 75% to 40%, and the residual volume increased by 1 L. In the second patient, aged 54 years, cough and dyspnea developed after ten months of therapy. The FEV₁/FVC% was 56%, the FEV₁ was 0.9 L, and the roentgenogram was normal. Lung biopsy specimens demonstrated severe and widespread bronchiolitis. An association between obliterative bronchiolitis and rheumatoid arthritis has been reported. Penicillamine may impair healing of bronchiolitis in such patients.

(JAMA 242:528-532, 1979)

Author Affiliations
From Thoracic Services and Pulmonary Medicine (Drs Epler, Snider, Gaensler, and Fitz-Gerald), Department of Arthritis and Connective Tissue Diseases (Dr Cathcart), Boston University School of Medicine; and Department of Pathology (Dr; Carrington), Stanford University School of Medicine, Palo Alto, Calif.

Footnotes
Reprint requests to Boston University School of Medicine, 80 E Concord St, Boston, MA 02118 (Dr Epler).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Unusual Dyspnea in a Woman With CREST Syndrome
Tzeng et al.
Chest 2008;133:286-290.
FULL TEXT  

Challenges in pulmonary fibrosis {middle dot} 2 : Bronchiolocentric fibrosis
Cordier
Thorax 2007;62:638-649.
ABSTRACT | FULL TEXT  

Bronchiolitis: The Pathologist's Perspective
Visscher and Myers
Proc Am Thorac Soc 2006;3:41-47.
ABSTRACT | FULL TEXT  

Histopathologic Pattern and Clinical Features of Rheumatoid Arthritis-Associated Interstitial Lung Disease
Lee et al.
Chest 2005;127:2019-2027.
ABSTRACT | FULL TEXT  

59-Year-Old Woman With Progressive Dyspnea on Exertion
Niewold and Ryu
Mayo Clin Proc. 2004;79:1567-1570.
 

Bronchiolar Disorders
Ryu et al.
Am. J. Respir. Crit. Care Med. 2003;168:1277-1292.
ABSTRACT | FULL TEXT  

Follicular Bronchiolitis: Thin-Section CT and Histologic Findings
Howling et al.
Radiology 1999;212:637-642.
ABSTRACT | FULL TEXT  

Case 11-1998- A 35-Year-Old Woman with Obstructive Pulmonary Disease and Cystic Changes on CT Scans of the Chest
Epler and Mark
NEJM 1998;338:1051-1058.
FULL TEXT  

Obliterative Bronchiolitis After Lung and Heart-Lung Transplantation
Reichenspurner et al.
Ann. Thorac. Surg. 1995;60:1845-1853.
ABSTRACT | FULL TEXT  

Toxicity of D-Penicillamine in Rheumatoid Arthritis
O'BRIEN
ANN INTERN MED 1980;92:120-122.
ABSTRACT