title: [Acetylcholine receptor antibody in D-penicillamine therapy].
abstract: Since 1978 a 63-year-old woman with rheumatoid arthritis received D-penicillamine (D-PA) in a daily dose of 250-500 mg (mean 300 mg/d). In 1982 the patient complained of diplopia for several days, the ophthalmological and neurological examinations three days later were normal. In July 1983 she developed a myasthenic syndrome, D-PA was stopped and treatment with mestinon was started. At this time anti-acetylcholine-receptor-antibodies (anti-AChR) were detectable in the patient's serum. The examination of sera stored at -80 degrees C since 1978 revealed anti-AChR existing since 1981 -1 1/2 years, however, before the temporary diplopia. Therefore in 13 other patients receiving D-PA for more than one year anti-AChR were examined. In two of these patients anti-AChR were found. The electroneurological tests were (still?) normal. The question arises whether anti-AChR should be measured routinely in patients with D-PA.
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000276:immunology; D001323:Autoantibodies / Q000032:analysis*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000139:chemically induced* / Q000276:immunology; D010396:Penicillamine / Q000009:adverse effects* / Q000627:therapeutic use; D011950:Receptors, Cholinergic / Q000276:immunology*
chemical_list: D001323:Autoantibodies; D011950:Receptors, Cholinergic; D010396:Penicillamine
vernacular_title: Azetylcholin-Rezeptorantikörper unter D-Penicillamintherapie.