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Eight patients with cystine stones (7 adults, 1 children) are treated by D-penicillamine since at least 5 years and at the most 9 years. The goal of the treatment is to obtain free cystinuria concentration less than 200 mg/l by the conjunction of a high urine flow and D-penicillamine. Cystinuria is measured by automatic analyser chromatography. In 2 patients, lithiasis got worse and cystinuria remained highly pathologic because bad compliance. In the 6 other cases, no lithiasis recurrence was noted; 5 patients had renal unilateral or bilateral lithiasis before treatment. A partial stone dissolution was obtained in 3 patients and total stone dissolution in 1 patient. Despite important posology often used, D-penicillamine has been remarkably well tolered since the only side effect observed was erythrodermia in 1 case at the beginning of the treatment.
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