4903
Reinstitution of penicillamine treatment caused a recurrence thus proving a causal relationship between penicillamine and the described nail - changes .
 adverse effect: nail - changes, penicillamine
Given options, please tell me the relationships of all the listed entity pairs.Output format is "relation1: word1, word2; relation2: word3, word4". 
Option: adverse effect 
Text: {0} 
 Entity Pairs:  nail - changes, penicillamine 
Answer:
 adverse effect: nail - changes, penicillamine