Summary
The action of D-penicillamine on collagen can cause undesired side-effects in the treatment of cystinuria and Wilson's disease, it is on the other hand essential to the therapy of rheumatoid arthritis and scleroderma. Furthermore D-penicillamine can be potentially teratogenic, since it crosses the placental barrier. From the literature and our own observation of two pregnancies it is shown that among 87 pregnant women who received D-penicillamine 46 cases were treated during the whole period of pregnancy. Two infants from the latter group were found to have severe connective-tissue defects. We suggest that the dose of D-penicillamine in pregnant patients with cystinuria and Wilson's disease should be kept as low as possible. In the case of rheumatoid arthritis D-penicillamine should not be given during pregnancy.
Zusammenfassung
Die Kollagenwirkung von D-Penicillamin stellt bei der Behandlung der Cystinurie und des M. Wilson eine unerwünschte Nebenwirkung dar, bei rheumatoider Arthritis und Sklerodermie macht sie jedoch die therapeutische Wirkung aus. Da D-Penicillamin die Placentarschranke überschreitet, muß auch eine teratogene Wirkung bedacht werden. Aus der Literatur sind, zusammen mit zwei eigenen Beobachtungen, die Ausgänge von 87 Schwangerschaften bekannt, darunter 46, in denen während der ganzen Schwangerschaftsdauer D-Penicillamin verabreicht worden war. Zwei Neugeborene der letzteren wiesen schwere Bindegewebsdefekte auf. Die D-Penicillamin-Dosis sollte bei schwangeren Cystinurie- und Wilson-Patientinnen so niedrig wie möglich gehalten werden. Bei Frauen mit rheumatoider Arthritis sollte man D-Penicillamin während der Schwangerschaft durch andere Medikamente ersetzen.
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Endres, W. D-penicillamine in pregnancy — to ban or not to ban?. Klin Wochenschr 59, 535–537 (1981). https://doi.org/10.1007/BF01716453
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DOI: https://doi.org/10.1007/BF01716453