A comprehensive case report and review of D-penicillamine-induced pancytopenia in Wilson's disease

Summary Wilson's disease is potentially treatable with pharmacological agents, including chelators that increase urinary copper excretion (D-penicillamine or Trientine) and zinc salts. Long-term use of D-penicillamine may result in a variety of adverse effects, including haematological disorders that can span almost the entire spectrum of haematology, including the coagulation system. There are very few cases noted with D-penicillamine-related pancytopenia. Here we report an interesting case of an adolescent girl who was diagnosed with Wilson's disease and started with D-penicillamine and continued for 1.5 years, when she developed drug-induced pancytopenia. Stopping the offender's drug use helped the girl to improve, and subsequently, she had to be managed with Trientine.