Stone Dissolution in Vivo and Control of Cystinuria with D-Penicillamine

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Abstract
CYSTINURIA is a hereditary defect in the renal tubular reabsorption of cystine, ornithine, arginine and lysine.1 Because of the relative insolubility of cystine precipitation occurs and stone formation results. Limited therapeutic success has been reported with increased fluid intake,2 alkalinization of the urine3 and dietary restriction of methionine.4 Crawhall et al.5 , 6 recently reported a marked decrease in twenty-four-hour urinary cystine excretion in several patients with cystinuria during brief treatment with penicillamine.§ This report describes the effects of penicillamine therapy in 3 patients with cystinuria, including 1 patient with a large cystine stone.Case ReportsCase 1. P.A.'s 1st renal symptoms . . .