title: Fatal polymyositis in D-penicillamine-treated rheumatoid arthritis.
abstract: Thirteen reports of patients who developed polymyositis or dermatomyositis during treatment with D-penicillamine are reviewed and a fourteenth case is described. Twelve of the fourteen patients recovered after D-penicillamine was withdrawn; two patients died from cardiac involvement. Proximal muscle weakness was present in 13 patients and dermatomyositis in 4 patients. Dysphagia was the presenting symptom in 6 patients. Although D-penicillamine is useful in the management of rheumatoid arthritis, this drug should be used with caution and patients monitored closely for evidence of polymyositis or dermatomyositis.
mesh_terms: D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D005260:Female; D006327:Heart Block / Q000139:chemically induced; D006801:Humans; D008875:Middle Aged; D009205:Myocarditis / Q000139:chemically induced; D009220:Myositis / Q000139:chemically induced*; D010396:Penicillamine / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D010396:Penicillamine