The Relationship between Aurothioglucose- and D-Penicillamine-Induced Proteinuria

F. Speerstra Department of Rheumatology, University Hospital St. Radboud, Nijmegen, The Netherlands; Ziekenzorg Hospital, Enschede, The Netherlands; Laboratory of Transplantation Serology, Blood Transfusion Service, University of Nijmegen, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus University, Rotterdam, The Netherlands

L. B. A. Van de Putte Department of Rheumatology, University Hospital St. Radboud, Nijmegen, The Netherlands; Ziekenzorg Hospital, Enschede, The Netherlands; Laboratory of Transplantation Serology, Blood Transfusion Service, University of Nijmegen, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus University, Rotterdam, The Netherlands

J. J. Rasker Department of Rheumatology, University Hospital St. Radboud, Nijmegen, The Netherlands; Ziekenzorg Hospital, Enschede, The Netherlands; Laboratory of Transplantation Serology, Blood Transfusion Service, University of Nijmegen, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus University, Rotterdam, The Netherlands

P. Reekers Department of Rheumatology, University Hospital St. Radboud, Nijmegen, The Netherlands; Ziekenzorg Hospital, Enschede, The Netherlands; Laboratory of Transplantation Serology, Blood Transfusion Service, University of Nijmegen, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus University, Rotterdam, The Netherlands

J. P. Vandenbroucke Department of Rheumatology, University Hospital St. Radboud, Nijmegen, The Netherlands; Ziekenzorg Hospital, Enschede, The Netherlands; Laboratory of Transplantation Serology, Blood Transfusion Service, University of Nijmegen, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus University, Rotterdam, The Netherlands

Abstract

We studied patients with rheumatoid arthritis who have been treated with aurothioglucose (Au) and subsequently with D-penicillamine (DP), and who developed drug-induced proteinuria, over a 10-year period. Twelve patients developed Au-induced and 19 DP-induced proteinuria. Of the 12 patients with Au-induced proteinuria, only 2 (17%) developed DP-induced proteinuria, indicating a slightly increased risk as compared with the overall incidence (9.3 %) of this reaction in 168 DP-treated patients. In addition, only a minority (2 out of 19, 10.6%) of patients with DP-induced proteinuria had previous Au-induced proteinuria. These data may indicate that different mechanisms are operative in Au and DP-induced proteinuria, as is also suggested by the finding that HLA-DR3 was present more frequently in the latter (50%) than in the former (21 %). A history of previous Au-induced proteinuria is insufficient reason to deny these patients the benefits of subsequent treatment with DP.

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The Relationship between Aurothioglucose- and D-Penicillamine-Induced Proteinuria

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