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The Drug-Induced Respiratory Disease Website and App

Penicillamine

The cis or dextro (d-) isomer of penicillamine. The drug is rarely used nowadays.

Frequency - Incidence

Incidence of respiratory adverse event(s) due to the specific drug as assessed by number of reported/published cases in the literature. Red digits in stars indicate: 0 = Very rare, questionable signal · 1 = < 10 cases · 2 = 10-50 cases · 3 = 50–100 cases · 4 = 100-200 cases · 5 = >200 cases

Evidence level/grade

Evidence level for respiratory adverse event(s) due to the specific drug as estimated using Hill’s (1965), Naranjo’s (1981), and Bégaud’s (1985) criteria applied to published cases. Blue digits in stars indicate: 0 = Questionable · 1 = Low · 2 = Moderate · 3 = Robust · 4 = Definite · 5 = Unquestionable, pathognomonic

I - Interstitial/parenchymal lung disease

I.a

Pneumonitis (ILD), acute and/or severe (may produce the ARDS pattern)
I.b

Pneumonitis (interstitial lung disease/ILD)
I.c

Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia)
I.d

Organizing pneumonia pattern (an area or areas of consolidation on imaging)
I.w

Rapidly progressive ILD/pulmonary fibrosis (Hamman-Rich syndrome)
I.y

Progression, acceleration or exacerbation of preexisting ILD/fibrosis
I.bc

Progression or exacerbation of preexisting/underlying rheumatoid arthritis-associated ILD

II - Pulmonary edema - Acute lung injury - ARDS

II.b

ARDS - Acute lung injury

III - Pulmonary/alveolar/airway hemorrhage/bleeding

III.a

Alveolar hemorrhage (AH), diffuse AH (DAH)
III.b

Pneumorenal syndrome (w/wo ANCAs)
III.d

Alveolar hemorrhage, diffuse (ANCA-positive/-related)

IV - Airway involvement

IV.a

Bronchospasm - Wheezing - Asthma
IV.c

Obliterative bronchiolitis (a pattern consistent with) (see also IVn, XVx)
IV.n

Obstructive airway dysfunction (see also IVc, XVx)

V - Pleural and/or pericardial involvement

V.a

Pleural effusion (uni- or bilateral) (can accompany DI-LDs)

IX - Neuromuscular / CNS involvement - Disordered breathing (during sleep)

IX.a

Diaphragm/inspiratory muscle weakness/paralysis (w/wo ARF)
IX.r

Myasthenia gravis - Myasthenic-like syndrome

X - Systemic/Distant conditions, syndromes and reactions

X.d

Lupus - Lupus syndrome (see also Vd)
X.e

Autoimmunity-Autoimmune conditions (+ANA, +anti-ds-DNA, +ANCAs, other auto-Abs)
X.j

Myopathy-Myositis-Polymyositis (see also under Xba)
X.s

Vasculitis, pulmonary (w/wo AH), extrapulmonary, systemic: ANCA-positive
X.ac

Anti-GBM antibody disease (Goodpasture-like or flare of preexisting GS)

XI - Miscellaneous

XI.t

Yellow nail syndrome

XV - Pathology

XV.z

Path: Obliterative (constrictive) bronchiolitis (see also IVc, IVn)

XVII - Infections & related conditions

XVII.w

Hypogammaglobulinemia - Antibody deficiency