[Dermatopolymyositis induced by D-penicillamine in rheumatoid polyarthritis. Apropos of 1 case with review of the literature].
Treatment of rheumatoid arthritis (RA) with D-penicillamine (DP) is associated with development of dermatopolymyositis (DPM) in 0.2 to 1.2% of cases. A case of DPM which developed after four years DP therapy in a 58-year-old female with RA is reported. The favorable outcome after discontinuation of DP and administration of corticosteroids and the absence of recurrence or malignant disease after 4 years 9 months follow-up demonstrated the causal relationship between DP therapy and development of DPM. An analysis of 34 previously published cases of DP-induced DPM (DP/DPM) showed the following: development of DPM was not influenced by the dosage or duration of DP therapy; reported cases of DP/DPM were clinically identical with primary DPM but had a different outcome, with permanent recovery of DP/DPM occurring 1.5 to 6 months after withdrawal of DP; patients with DP/DPM had immune disorders, including antinuclear antibodies in 14 of 34 patients; the high prevalence of the B18, B35, DR4 haplotype in these patients denotes immunogenetic differences with primary DPM patients (B8-DR3) and DP-induced myasthenia (DR1).
Kolsi
R
R
Service de Médecine Interne et de Rhumatologie, Hôpital Universitaire Hedi Chaker, Sfax, Tunisie.
Bahloul
Z
Z
Hachicha
J
J
Gouiaa
R
R
Jarraya
A
A
D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D003882:Dermatomyositis / Q000139:chemically induced* / Q000276:immunology; D005260:Female; D006801:Humans; D008875:Middle Aged; D010396:Penicillamine / Q000009:adverse effects* / Q000627:therapeutic use
D010396:Penicillamine
Dermatopolymyosite induite par la D-pénicillamine au cours de la polyarthrite rhumatoïde. A propos d'un cas avec revue de la littérature.