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. 1987 Nov;62(11):1118–1124. doi: 10.1136/adc.62.11.1118

Clinical trials of penicillamine in Indian childhood cirrhosis.

M S Tanner 1, S A Bhave 1, A M Pradhan 1, A N Pandit 1
PMCID: PMC1778525  PMID: 3318711

Abstract

The outcome in 15 children with advanced Indian childhood cirrhosis (ICC) treated with penicillamine 20 mg/kg/day was not significantly different from that in untreated children. Among children admitted to a further double blind trial who had ICC but who had not yet developed jaundice or ascites 10 treated with penicillamine and 10 treated with penicillamine plus prednisolone had a significantly improved survival. Fourteen of 29 treated cases made a clinical recovery and were alive 489 to 1460 days from the start of treatment. Biopsy specimens in survivors showed a return to normal liver histology in three, residual fibrosis in six, and inactive micronodular cirrhosis in five. Thus penicillamine, while not shown to be beneficial in advanced ICC, lowered mortality from 93% to 52% in preicteric cases of ICC.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bhave S. A., Pandit A. N., Pradhan A. M., Sidhaye D. G., Kantarjian A., Williams A., Talbot I. C., Tanner M. S. Liver disease in India. Arch Dis Child. 1982 Dec;57(12):922–928. doi: 10.1136/adc.57.12.922. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Bhave S. A., Pandit A. N., Tanner M. S. Comparison of feeding history of children with Indian childhood cirrhosis and paired controls. J Pediatr Gastroenterol Nutr. 1987 Jul-Aug;6(4):562–567. doi: 10.1097/00005176-198707000-00013. [DOI] [PubMed] [Google Scholar]
  3. Gooneratne S. R., Howell J. M., Gawthorne J. M. An investigation of the effects of intravenous administration of thiomolybdate on copper metabolism in chronic Cu-poisoned sheep. Br J Nutr. 1981 Nov;46(3):469–480. doi: 10.1079/bjn19810055. [DOI] [PubMed] [Google Scholar]
  4. Gooneratne S. R., Howell J. M., Gawthorne J. M. Intravenous administration of thiomolybdate for the prevention and treatment of chronic copper poisoning in sheep. Br J Nutr. 1981 Nov;46(3):457–467. doi: 10.1079/bjn19810054. [DOI] [PubMed] [Google Scholar]
  5. Kalra V., Ghai O. P., Roy S. Immuno-modulation: a therapeutic approach in Indian childhood cirrhosis. Indian Pediatr. 1981 Apr;18(4):247–252. [PubMed] [Google Scholar]
  6. Lengfelder E., Fuchs C., Younes M., Weser U. Functional aspects of the superoxide dismutative action of Cu-penicillamine. Biochim Biophys Acta. 1979 Apr 12;567(2):492–502. doi: 10.1016/0005-2744(79)90135-9. [DOI] [PubMed] [Google Scholar]
  7. Nayak N. C., Ramalingaswami V. Indian childhood cirrhosis. Clin Gastroenterol. 1975 May;4(2):333–349. [PubMed] [Google Scholar]
  8. Nazer H., Ede R. J., Mowat A. P., Williams R. Wilson's disease: clinical presentation and use of prognostic index. Gut. 1986 Nov;27(11):1377–1381. doi: 10.1136/gut.27.11.1377. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Pandit A. N., Bhave S. A., Sidhaye D. G., Datar G. V. Palpable gall bladder in Indian childhood cirrhosis. Indian Pediatr. 1981 Dec;18(12):905–908. [PubMed] [Google Scholar]
  10. Popper H., Goldfischer S., Sternlieb I., Nayak N. C., Madhavan T. V. Cytoplasmic copper and its toxic effects. Studies in Indian childhood cirrhosis. Lancet. 1979 Jun 9;1(8128):1205–1208. doi: 10.1016/s0140-6736(79)91894-4. [DOI] [PubMed] [Google Scholar]
  11. Raju V. B., Sundaravalli N., Sriramachari S. Indian childhood cirrhosis: clinical features, prognosis and treatment. Indian J Pediatr. 1980 Nov-Dec;47(389):537–541. doi: 10.1007/BF02822546. [DOI] [PubMed] [Google Scholar]
  12. Roberts N. A., Robinson P. A. Copper chelates of antirheumatic and anti-inflammatory agents: their superoxide dismutase-like activity and stability. Br J Rheumatol. 1985 May;24(2):128–136. doi: 10.1093/rheumatology/24.2.128. [DOI] [PubMed] [Google Scholar]
  13. Tanner M. S., Kantarjian A. H., Bhave S. A., Pandit A. N. Early introduction of copper-contaminated animal milk feeds as a possible cause of Indian childhood cirrhosis. Lancet. 1983 Oct 29;2(8357):992–995. doi: 10.1016/s0140-6736(83)90980-7. [DOI] [PubMed] [Google Scholar]
  14. Tanner M. S., Portmann B. Indian childhood cirrhosis. Arch Dis Child. 1981 Jan;56(1):4–6. doi: 10.1136/adc.56.1.4. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Tanner M. S., Portmann B., Mowat A. P., Williams R., Pandit A. N., Mills C. F., Bremner I. Increased hepatic copper concentration in Indian childhood cirrhosis. Lancet. 1979 Jun 9;1(8128):1203–1205. doi: 10.1016/s0140-6736(79)91893-2. [DOI] [PubMed] [Google Scholar]

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