Letter: Fatal aplastic anaemia and D-penicillamine

A case report and focused literature review of d-penicillamine and severe neutropenia: A serious toxicity from a seldom-used drug

Prescribing d-penicillamine for Wilson's disease must be accompanied by vigilant monitoring, including a complete blood cell count with differential. For most, this should occur once or twice weekly during the first month of therapy and during periods of dose escalation, then every two weeks for six additional months, then monthly.

Cytogenetic studies in patients treated with penicillamine

Cytogenetic studies were performed on bone-marrow cells from 11 patients with rheumatoid arthritis treated with penicillamine. One of the patients was studied while developing a granulocytopenia and thrombocytopenia. The findings show that penicillamine had no chromosome-damaging effect as estimated by the micronucleus test and by the number of structural chromosomal aberrations.