To investigate the possible relation between certain HLA antigens and toxicity during treatment with sodium aurothiomalate of D-penicillamine, we studied 91 patients with rheumatoid arthritis. Seventy-one had toxic reactions to either drug or both drugs; the remaining 20 took one of the drugs for at least six months, without toxicity. Nineteen of 24 patients in whom proteinuria developed were positive for HLA-B8 and HLA-DRW3 antigens; 14 of 15 episodes of aurothiomalate-induced proteinura and nine of 13 episodes of penicillamine-induced proteinura occurred in patients with these antigens. All 13 episodes of proteinuria in which urinary protein exceeded 2 g in 24 hours occurred in patients with DRw3. The relative risk of proteinuria during treatment with aurothiomalate is increased 32 times in patients who are HLA-DRw3 positive. No significant associations were found between any HLA antigen and development of skin rashes or hematologic complications. Toxicity during aurothiomalate or penicillamine treatment for rheumatoid arthritis may be under genetic control.
This article has been cited by other articles:
GUNNARSSON, I, RINGERTZ, B, BRATT, J, SUNDELIN, B
(2001). HLA-DRB1*0301 and DQA1*0501 in RA. Ann Rheum Dis
60: 727-727
[Full Text]
Gunnarsson, I., Nordmark, B., Hassan Bakri, A., Grondal, G., Larsson, P., Forslid, J., Klareskog, L., Ringertz, B.
(2000). Development of lupus-related side-effects in patients with early RA during sulphasalazine treatment--the role of IL-10 and HLA. Rheumatology (Oxford)
39: 886-893
[Abstract][Full Text]
Turbay, D., Lieberman, J., Alper, C. A., Delgado, J. C., Corzo, D., Yunis, J. J., Yunis, E. J.
(1997). Tumor Necrosis Factor Constellation Polymorphism and Clozapine-Induced Agranulocytosis in Two Different Ethnic Groups. Blood
89: 4167-4174
[Abstract][Full Text]
Lieberman, J. A., Yunis, J., Egea, E., Canoso, R. T., Kane, J. M., Yunis, E. J.
(1990). HLA-B38, DR4, DQw3 and Clozapine-Induced Agranulocytosis in Jewish Patients With Schizophrenia. Arch Gen Psychiatry
47: 945-948
[Abstract]
Roujeau, J.-C., Huynh, T. N., Bracq, C., Guillaume, J.-C., Revuz, J., Touraine, R.
(1987). Genetic Susceptibility to Toxic Epidermal Necrolysis. Arch Dermatol
123: 1171-1173
[Abstract]
STEEN, V. D., BLAIR, S., MEDSGER, T. A. Jr.
(1986). The Toxicity of D-Penicillamine in Systemic Sclerosis. ANN INTERN MED
104: 699-705
[Abstract]
Vesell, E. S.
(1985). Implications for Risk Assessment of Host Factors Causing Large Pharmacokinetic Variations. Toxicol Ind Health
1: 135-152
[Abstract]
KATZ, W. A., BLODGETT, R. C. Jr., PIETRUSKO, R. G.
(1984). Proteinuria in Gold-Treated Rheumatoid Arthritis. ANN INTERN MED
101: 176-179
[Abstract]
Van Riel, P. L. C. M., van de Putte, L. B. A., Gribnau, F. W. J., de Waal, R. M. W.
(1984). Serum IgA and Gold-Induced Toxic Effects in Patients With Rheumatoid Arthritis. Arch Intern Med
144: 1401-1403
[Abstract]
(1983). Rheumatology: An Annotated Bibliography of Recent Literature: References to Journal Articles and Other Papers. ANN INTERN MED
98: 264-269
[Abstract]
CHALMERS, A., THOMPSON, D., STEIN, H. E., REID, G., PATTERSON, A. C.
(1982). Systemic Lupus Erythematosus During Penicillamine Therapy for Rheumatoid Arthritis. ANN INTERN MED
97: 659-663
[Abstract]
Multz, C. V.
(1981). Cholestatic Hepatitis Caused by Penicillamine. JAMA
246: 674-675
[Abstract]
COBLYN, J. S., WEINBLATT, M., HOLDSWORTH, D., GLASS, D.
(1981). Gold-Induced Thrombocytopenia: A Clinical and lmmunogenetic Study of Twenty-three Patients. ANN INTERN MED
95: 178-181
[Abstract]
Previous
