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Case Reports
. 2014 Oct 29;5(1):30-8.
doi: 10.1159/000368826. eCollection 2015 Jan-Apr.

Bucillamine-induced membranous nephropathy with crescent formation in a patient with rheumatoid arthritis: case report and literature review

Shun Manabe  1 , Mayuko Banno  1 , Marie Nakano  1 , Teruhiro Fujii  1 , Michio Fujiwara  2 , Yasuhiko Kita  2 , Kosaku Nitta  3 , Michiyasu Hatano  1
Affiliations
Case Reports

Bucillamine-induced membranous nephropathy with crescent formation in a patient with rheumatoid arthritis: case report and literature review

Shun Manabe et al. Case Rep Nephrol Dial. .

Abstract

Bucillamine is a disease-modifying antirheumatic drug that is structurally similar to D-penicillamine. The major renal side effect of bucillamine and D-penicillamine is proteinuria caused by membranous nephropathy (MN). In addition to MN, combined crescent formation has been occasionally reported in D-penicillamine-induced MN, while crescent formation has been rarely reported in bucillamine-treated cases. Here, we describe a 76-year-old female who presented with nephrotic syndrome and rapidly progressive glomerulonephritis. She was receiving bucillamine as initial treatment for recently diagnosed rheumatoid arthritis, and renal biopsy showed MN with crescent formation. To the best of our knowledge, this is the first report of bucillamine-induced MN with crescent formation in the English literature.

Keywords: Bucillamine; Crescent formation; Membranous nephropathy; Nephrotic syndrome; Rapidly progressive glomerulonephritis; Rheumatoid arthritis.

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Figures

Fig. 1
Fig. 1
Clinical course after the initiation of bucillamine therapy.
Fig. 2
Fig. 2
Light microscopy findings of the renal biopsy. a Mild intracapillary proliferation and small cellular crescents. Periodic acid Schiff staining. ×40. b Global cellular crescent. Periodic acid methenamine silver staining. ×100. IF findings: fine granular staining of IgG (c), IgG1 (d), IgG2 (e), IgG3 (f), and IgG4 (g) on the glomerular capillary loop.
Fig. 3
Fig. 3
EM findings. a Subepithelial electron-dense deposits (white arrow heads). Original magnification ×6,000. b Extensive foot process effacement, microvillus transformation, and vacuolar degeneration of podocytes. Original magnification ×2,000.
See this image and copyright information in PMC

References

    1. Wood PL, Khan MA, Moskal JR, et al. Mechanism of action of the disease-modifying anti-arthritic thiol agents D-penicillamine and sodium aurothiomalate: restoration of cellular free thiols and sequestration of reactive aldehydes. Eur J Pharmacol. 2008;580:48–54. - PubMed
    1. Yoshida A, Morozumi K, Suganuma T, et al. Clinicopathological findings of bucillamine-induced nephrotic syndrome in patients with rheumatoid arthritis. Am J Nephrol. 1991;11:284–288. - PubMed
    1. Obayashi M, Uzu T, Harada T, et al. Clinical course of bucillamine-induced nephropathy in patients with rheumatoid arthritis. Clin Exp Nephrol. 2003;7:275–278. - PubMed
    1. Hoshino J, Ubara Y, Hara S, et al. Outcome and treatment of bucillamine-induced nephropathy. Nephron Clin Pract. 2006;104:c15–c19. - PubMed
    1. Habib GS, Saliba W, Nashashibi M, et al. Penicillamine and nephrotic syndrome. Eur J Intern Med. 2006;17:343–348. - PubMed

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