Outcome and treatment of bucillamine-induced nephropathy.

Abstract

BACKGROUND:

Bucillamine (BCL), a treatment for rheumatoid arthritis, occasionally causes proteinuria. Renal specimens are reported to show segmental granular deposition of immunoglobulin G, associated with membranous nephropathy. Long-term course and optimal treatment have remained unknown, and were investigated here.

METHODS:

We examined clinical records of 400 patients treated with BCL for rheumatoid arthritis, at our hospital from 1998 to 2003, finding 17 with proteinuria and biopsy-proven BCL-induced nephropathy.

RESULTS:

In all 17 patients, proteinuria resolved without loss of renal function between 3 and 85 months after discontinuing BCL (14.1 +/- 3.4). The only factor influencing time to remission was pathologic stage of membranous nephropathy (stage I vs. stage II or III: 11.5 +/- 4.8 vs. 21.6 +/- 3.3 months; p = 0.02). Maximal proteinuria, total amount of BCL, BCL exposure time, and use of prednisolone or other immunosuppressant agents did not significantly influence time until remission.

CONCLUSION:

The most important therapeutic step in treating BCL-induced nephropathy is to discontinue BCL. Prednisolone or other immunosuppressant agents might not be effective.

• Authors: Junichi Hoshino, Yoshifumi Ubara, Shigeo Hara, Tatsuya Suwabe, Naoki Sawa, Tetsuo Tagami, Hideyuki Katori, Fumi Takemoto, Shigeko Hara, Kenmei Takaichi
• Journal: Nephron. Clinical practice (Nephron Clin Pract) Vol. 104 Issue 1 Pg. c15-9 ( 2006) ISSN: 1660-2110 [Electronic] Switzerland
• PMID: 16685139 (Publication Type: Journal Article)
• Copyright: Copyright 2006 S. Karger AG, Basel.

Chemical References

• Anti-Inflammatory Agents, Non-Steroidal
• Cysteine
• bucillamine

Topics

• Adult
• Aged
• Anti-Inflammatory Agents, Non-Steroidal (adverse effects)
• Arthritis, Rheumatoid (complications, drug therapy)
• Cysteine (adverse effects, analogs & derivatives)
• Drug Administration Schedule
• Female
• Glomerulonephritis, Membranous (chemically induced, pathology, therapy)
• Humans
• Kidney (drug effects, pathology)
• Male
• Middle Aged
• Proteinuria (chemically induced, therapy)
• Remission Induction