[Clinical and prognostic significance of antinuclear factors during D-penicillamine treatment (author's transl)].

Antinuclear factors were demonstrated during D-penicillamine treatment in patients with rheumatiod arthritis (72) and scleroderma (7). While in 13 antinuclear factors were demonstrable already before treatment was started, they occurred in the course of treatment in another 34. D-penicillamine administration had to be discontinued in 18 because of severe side effects, with a marked correlation between their severity and the presence of antinuclear factors. Side effects requiring stoppage of the drug were especially common in patients who had antinuclear factors even before onset of treatment. The severest complication of D-penincillamine treatment, renal damage, was found only in patients with antinuclear factors, in this instance antibodies against denatured DNA. The following therapeutic consequences should be drawn from these findings: (1) D-penicillamine should, if possible, not be given to any patient with antinuclear factors; (2) in patients in whom antinuclear factors occur in the course of D-penicillamine treatment but its administration is to be continued, blood picture, renal functions and urine must be regularly tested.