Case Report

Goodpasture-like Syndrome Induced by D-Penicillamine in a Patient with Systemic Sclerosis: Report and Review of the Literature

CHRIS T. DERK and SERGIO A. JIMENEZ

ABSTRACT.

We report a case of Goodpasture-like syndrome developing in a patient who was treated with D-penicillamine for the diffuse form of systemic sclerosis. This unusual pulmonary-renal syndrome has been described on rare occasions in patients receiving D-penicillamine. This complication appeared to be uniformly fatal unless treated with aggressive immunotherapy. We review the cases reported to date in the literature and describe the clinical characteristics, therapy, and outcome of this group of patients. (J Rheumatol 2003;30:1616-20)

Key Indexing Terms:

SYSTEMIC SCLEROSIS
D-PENICILLAMINE
GOODPASTURE SYNDROME
CRESCENTIC GLOMERULONEPHRITIS
PULMONARY HEMORRHAGE

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From the Division of Rheumatology, Department of Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.

Supported by NIH Grant AR19616. Dr. Derk was supported by NIH Training Grant AR07583.

C.T. Derk, MD, Senior Clinical Fellow; S.A. Jimenez, MD, Professor of Medicine, Professor of Biochemistry and Molecular Pharmacology, Director, Division of Rheumatology.

Address reprint requests to Dr. C.T. Derk, Division of Rheumatology, Thomas Jefferson University, 233 South 10th Street, Room 509 BLSB, Philadelphia, PA 19107-5541. E-mail: chris.derk@mail.tju.edu

Submitted September 27, 2002; revision accepted December 31, 2002.

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