Autoantibodies in D-penicillamine-induced myasthenia gravis: a comparison with idiopathic myasthenia and rheumatoid arthritis.
The distribution of autoantibodies was studied in patients with rheumatoid arthritis (RA) treated by D-penicillamine and who developed myasthenia gravis (MG). The anti-human acetylcholine receptor (AChR) antibodies were specifically associated with clinical symptoms of MG without any difference in the pattern of specificities in idiopathic (id-MG) or in induced MG (DPen-MG). Conversely, anti-nuclear antibodies were elevated in DPen-MG sera compared to id-MG sera (P less than 0.001) but were also compared to patients with RA treated by D-penicillamine (or thiopronine) and who did not develop MG. Anti-denatured DNA antibodies were enhanced in sera from treated patients, whether they had presented or not a MG disease. Anti-histone antibodies were associated with RA. These observations suggest that the immunological imbalance in RA patients, can be increased by a drug treatment which may trigger the appearance of a second autoimmune disease such as MG, where anti-AChR antibodies are associated with anti-nuclear antibodies.
Morel
E
E
INSERM U25, CNRS UA 122, Hôpital Necker, Paris, France.
Feuillet-Fieux
M N
MN
Vernet-der Garabedian
B
B
Raimond
F
F
D'Anglejan
J
J
Bataille
R
R
Sany
J
J
Bach
J F
JF
D000328:Adult; D000368:Aged; D000974:Antibodies, Antinuclear / Q000032:analysis; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy / Q000276:immunology*; D001323:Autoantibodies / Q000032:analysis*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005455:Fluorescent Antibody Technique; D006801:Humans; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000209:etiology / Q000276:immunology*; D010396:Penicillamine / Q000009:adverse effects* / Q000276:immunology; D011950:Receptors, Cholinergic / Q000276:immunology
D000974:Antibodies, Antinuclear; D001323:Autoantibodies; D011950:Receptors, Cholinergic; D010396:Penicillamine