Shahrekord University of Medical Sciences Journal of Shahrekord University of Medical Sciences 2717-0071 27 1 2025 04 26 Evaluating the efficacy of triple therapy incorporating low-dose D-penicillamine in pediatric patients with cystinuria: A case series analysis 41 43 10.34172/jsums.1028 EN Saeed Mohajeri https://orcid.org/0000-0003-3792-9596 Aliasghar Rabei https://orcid.org/0000-0003-0941-2012 Alizamen Salehifard Jouneghani https://orcid.org/0000-0001-6572-9394 Journal Article 10.34172/jsums.1028 2024 11 04 2024 11 17 Cystinuria is a hereditary disorder characterized by recurrent kidney stone formation, which poses significant challenges to affected individuals and their families. This study examines four pediatric cases of cystinuria referred to the Shahrekord Pediatric Nephrology Clinic in southwestern Iran over different time periods. Due to the presence of large and numerous stones, these patients experienced substantial renal injury, necessitating multiple surgical interventions and stone fragmentation procedures. Following the initiation of a medical treatment regimen that included low-dose D-penicillamine capsules (10 mg/kg daily), vitamin B6 tablets (4 mg/kg daily), and potassium citrate (1 mL/kg daily), none of the patients required further surgical intervention, underwent stone fragmentation, or experienced new renal damage. Additionally, no adverse effect related to the treatment was observed during several years of follow-up. The patients underwent routine laboratory tests and general ultrasound examinations every three months, and no drug-related complications were noted throughout the follow-up period.