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Thrombotic Thrombocytopenic Purpura During Penicillamine Therapy in Rheumatoid Arthritis

Thrombotic Thrombocytopenic Purpura During Penicillamine Therapy in Rheumatoid Arthritis Abstract • Thrombotic thrombocytopenic purpura (TTP) developed in a patient with seropositive rheumatoid arthritis (RA) after 2½ months of treatment with penicillamine. After discontinuation of the drug, plasmapheresis and steroid therapy led to a sustained remission. To our knowledge, no prior cases of penicillamine-induced TTP in RA have been reported. (Arch Intern Med 1983;143:1487-1488) References 1. Moschowitz E: An acute febrile pleiochromic anemia with hyaline thrombosis of the terminal arterioles and capillaries: An undescribed disease. Arch Intern Med 1925;36:89-93.Crossref 2. Case records of Massachusetts General Hospital. N Engl J Med 1960;263:193-198.Crossref 3. Case records of Massachusetts General Hospital. N Engl J Med 1963;269:577-583.Crossref 4. Goodman A, Ramos R, Petrelli M, et al: Gingival biopsy in thrombotic thrombocytopenic purpura. Ann Intern Med 1978;89:501-504.Crossref 5. Weiss AS, Markenson JA, Weiss MS, et al: Toxicity of D-penicillamine in rheumatoid arthritis. Am J Med 1978;64:114-120.Crossref 6. Kean WF, Dwosh IL, Anastassiades TA, et al: The toxicity pattern of D-penicillamine therapy. Arthritis Rheum 1980;23:158-164.Crossref 7. Stein HB, Patterson AC, Offer RC, et al: Adverse effects of D-penicillamine in rheumatoid arthritis. Ann Intern Med 1980;92:24-29.Crossref 8. Harrison EE, Hickman JW: Hemolytic anemia and thrombocytopenia associated with D-penicillamine therapy. South Med J 1975;68:113-115.Crossref 9. Ahmed F, Sumalnop V, Spain DM, et al: Thrombohemolytic thrombocytopenic purpura during penicillamine therapy. Arch Intern Med 1978; 138:1292-1293.Crossref 10. Neame PB: Immunologic and other factors in thrombotic thrombocytopenic purpura (TTP). Semin Thromb Hemostas 1980;6:416-429.Crossref 11. Kelton JG, Neame PB, Walker I, et al: Thrombotic thrombocytopenic purpura: Mechanism for effectiveness of plasmapheresis. Thromb Haemost 1979;42:115. 12. Morrison J, McMillan R: Elevated platelet associated IgG in thrombotic thrombocytopenic purpura. JAMA 1977;238:1944-1945.Crossref 13. Harrison EE, Hickman JW: D-penicillamine and hemolytic anemia. Lancet 1976;1:38.Crossref 14. Parker JC, Barrett DA II: Microangiopathic hemolysis and thrombocytopenia related to penicillin drugs. Arch Intern Med 1971;127:474-477.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Thrombotic Thrombocytopenic Purpura During Penicillamine Therapy in Rheumatoid Arthritis

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Publisher
American Medical Association
Copyright
Copyright © 1983 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1983.00350070215039
Publisher site
See Article on Publisher Site

Abstract

Abstract • Thrombotic thrombocytopenic purpura (TTP) developed in a patient with seropositive rheumatoid arthritis (RA) after 2½ months of treatment with penicillamine. After discontinuation of the drug, plasmapheresis and steroid therapy led to a sustained remission. To our knowledge, no prior cases of penicillamine-induced TTP in RA have been reported. (Arch Intern Med 1983;143:1487-1488) References 1. Moschowitz E: An acute febrile pleiochromic anemia with hyaline thrombosis of the terminal arterioles and capillaries: An undescribed disease. Arch Intern Med 1925;36:89-93.Crossref 2. Case records of Massachusetts General Hospital. N Engl J Med 1960;263:193-198.Crossref 3. Case records of Massachusetts General Hospital. N Engl J Med 1963;269:577-583.Crossref 4. Goodman A, Ramos R, Petrelli M, et al: Gingival biopsy in thrombotic thrombocytopenic purpura. Ann Intern Med 1978;89:501-504.Crossref 5. Weiss AS, Markenson JA, Weiss MS, et al: Toxicity of D-penicillamine in rheumatoid arthritis. Am J Med 1978;64:114-120.Crossref 6. Kean WF, Dwosh IL, Anastassiades TA, et al: The toxicity pattern of D-penicillamine therapy. Arthritis Rheum 1980;23:158-164.Crossref 7. Stein HB, Patterson AC, Offer RC, et al: Adverse effects of D-penicillamine in rheumatoid arthritis. Ann Intern Med 1980;92:24-29.Crossref 8. Harrison EE, Hickman JW: Hemolytic anemia and thrombocytopenia associated with D-penicillamine therapy. South Med J 1975;68:113-115.Crossref 9. Ahmed F, Sumalnop V, Spain DM, et al: Thrombohemolytic thrombocytopenic purpura during penicillamine therapy. Arch Intern Med 1978; 138:1292-1293.Crossref 10. Neame PB: Immunologic and other factors in thrombotic thrombocytopenic purpura (TTP). Semin Thromb Hemostas 1980;6:416-429.Crossref 11. Kelton JG, Neame PB, Walker I, et al: Thrombotic thrombocytopenic purpura: Mechanism for effectiveness of plasmapheresis. Thromb Haemost 1979;42:115. 12. Morrison J, McMillan R: Elevated platelet associated IgG in thrombotic thrombocytopenic purpura. JAMA 1977;238:1944-1945.Crossref 13. Harrison EE, Hickman JW: D-penicillamine and hemolytic anemia. Lancet 1976;1:38.Crossref 14. Parker JC, Barrett DA II: Microangiopathic hemolysis and thrombocytopenia related to penicillin drugs. Arch Intern Med 1971;127:474-477.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Jul 1, 1983

References