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Induction of auto-immune syndromes by penicillamine therapy in rheumatoid arthritis and other diseases

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Conclusion

Penicillamine and some structurally related compounds have been shown to be inducers of autoimmune phenomena when administered to patients, regardless of the underlying disease for which they are being given. Most of these reactions are serious and often mandate discontinuance of treatment, but the development of a particular adverse reaction to one SH compound does not necessarily mean that others will elicit a similar or indeed any adverse effect. Of great theoretical interest is the mechanism by which penicillamine, as the prototype of this class, results in apparent breakdown of tolerance to self-antigens. No clear answer to this extremely important question is forthcoming, probably due to limitations in contemporary methodology. It is believed that if the mechanism of these drug-induced events were understood, new insights into the immunologic aberrations in RA might be achieved.

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Jaffe, I.A. Induction of auto-immune syndromes by penicillamine therapy in rheumatoid arthritis and other diseases. Springer Semin Immunopathol 4, 193–207 (1981). https://doi.org/10.1007/BF01857095

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