1982 Volume 31 Issue 6 Pages 350-354
D-penicillamine (D-Pc) has been reported to have beneficial effects in treatment of rheumatoid arthritis (RA). A 55-year-old female with RA developed a rapid fall in white blood cell count after 6 weeks of D-Pc treatment at daily dose of 200mg. Bone marrow aspiration showed normal cellularity with a shift to the left. The peripheral white blood cell count result rapidly reversed within 6 days after discontinuation of the drug. We tried readministrating D-Pc (100mg) to her, when fifteen hours after intake of the drug, the white blood cell count decreased again repidly. No anti-leukocyte antibody was detected by the leukocyte lysis phenomenon method. But when the acute stage serum of this patient was added to the lymphocyte transformation response to concanavalin A, the proliferative response was suppressed markedly. Leukocytopenia is a rare side effect of D-Pc but it is potetially more harmful than other side effects. In treatment with D-Pc, therefore, the drug should be carefully administrated and regular blood examinations carried out to prevent the occurrence of this side effect.
