Expert Medical Testimony on Penicillamine Side Effects

July 1976 in “ JAMA ”

Maurice Kovnat

hair loss negative nitrogen balance protein intake

TLDR Penicillamine can cause taste problems due to copper loss, which can be fixed with copper or zinc supplements.

The document discussed the side effects of penicillamine, particularly taste dysfunction, which was observed in about one-third of patients with rheumatoid arthritis, scleroderma, or cystinuria, but rarely in those with Wilson disease. The taste dysfunction was linked to copper depletion, as indicated by significant hypocupremia and hypercupruria in affected patients. This condition was corrected by administering copper salts. Zinc therapy also helped but took longer to show effects. The study involved a balance study showing penicillamine caused a negative copper balance but a positive zinc balance. The document also mentioned hair loss associated with rapid weight loss, which was linked to a negative nitrogen balance and could be mitigated by increasing protein intake. This conclusion was based on data from over 200 patients.

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