Concurrent naproxen- and penicillamine-induced renal disease in rheumatoid arthritis

✍ Scribed by Matthew R. Quigley; Michael Richfield; Frank A. Krumlovsky; Yashpal S. Kanwar; Frank A. Carone; Mark P. Jarrett

• Publisher: John Wiley and Sons
• Year: 1982
• Tongue: English
• Weight: 399 KB
• Volume: 25
• Category: Article
• ISSN: 0004-3591
• DOI: 10.1002/art.1780250818

✦ Synopsis

Nonsteroidal antiinflammatory agents and other drugs have been reported to cause interstitial nephritis. Classically, the patient develops acute renal failure and allergic symptoms shortly after the start of drug treatment (1). Here, we report a patient with rheumatoid arthritis who developed interstitial nephritis and renal failure secondary to naproxen and membranous glomerulonephritis as a consequence of penicillamine administration (2-4). Despite the common practice of using penicillamine with a nonsteroidal antiinflammatory drug in the treatment of rheumatoid arthritis, there has been no report of 2 separate types of drug-induced renal lesions in a patient who is receiving both of these agents.

CASE REPORT

A 44-year-old old black woman was admitted to the hospital on November 25, 1980; she had a 10-day history of generalized edema associated with anorexia, nausea, and vomiting, and a 4Y2-year history of classic seronegative rheumatoid arthritis that was characterized by erosive changes on roentgenograms. Penicillamine, 250 mg/day, had been started in January 1979