title: [Neuromuscular complications of D-penicillamine in rheumatoid arthritis].
abstract: Between 1979 and 1990 we have seen 8 patients (7 females) with rheumatoid arthritis (RA) who developed a neuro-muscular involvement while on D-penicillamine (D.P.). Five of them had a drug-induced myasthenia. D.P. withdrawal led to a complete recovery in 1.5 to 5 months. Another patient presented with a myopathy which led to the diagnosis of Grave's disease. She was treated with D.P. for 4 months. D.P. was reintroduced and 5 months later a myasthenic syndrome developed. A thymoma was discovered 1 year later. In the last 2 patients D.P. induced polymyositis which, in one, was associated with features of systemic lupus erythematosus. In the other patient, the evolution was fatal in spite of D.P. withdrawal, high dose steroids and plasma exchanges. A literature survey has shown 150 D.P. induced myasthenia and 38 D.P. induced polymyositis cases.
authors.affiliation: Unité d'Immunologie Clinique et Service de Rhumatologie, Hôpital Saint-Jacques, Clermont-Ferrand.
authors.forename: J J
authors.initials: JJ
authors.lastname: Dubost
authors.forename: M
authors.initials: M
authors.lastname: Soubrier
authors.forename: F
authors.initials: F
authors.lastname: Bouchet
authors.forename: J L
authors.initials: JL
authors.lastname: Kemeny
authors.forename: R
authors.initials: R
authors.lastname: Lhopitaux
authors.forename: J L
authors.initials: JL
authors.lastname: Bussière
authors.forename: B
authors.initials: B
authors.lastname: Sauvezie
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D005260:Female; D006111:Graves Disease / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000139:chemically induced* / Q000150:complications; D009220:Myositis / Q000139:chemically induced* / Q000150:complications; D010396:Penicillamine / Q000009:adverse effects* / Q000627:therapeutic use; D013945:Thymoma / Q000150:complications; D013953:Thymus Neoplasms / Q000150:complications
chemical_list: D010396:Penicillamine
vernacular_title: Complications neuromusculaires de la D. pénicillamine dans la polyarthrite rhumatoïde.