title: [D-penicillamine induced myasthenic syndromes in rheumatoid arthritis. Two cases (author's transl)].
abstract: The authors report on 2 personal cases, and review 48 published cases of myasthenia induced by D-penicillamine (D-P) treatment in patients with rheumatoid arthritis. The clinical symptoms were not different from those of myasthenia gravis, and no correlation could be found between the total cumulative dose of D-P and the onset on the myasthenic syndrome. In 71% of the patients the neurological deficiency regressed after D-P was withdrawn, but in some cases anticholinesterase treatment had to be continued and thymectomy was contemplated. The most remarkable biological abnormalities were anti-striational antibodies (found in 58% of the cases) and anti-acetylcholine receptors antibodies (found in 4 out of 7 patients tested). These findings are in favour of a genuine myasthenia and against a myasthenic syndrome due to neuro-muscular blockade. While the mechanisms underlying the emergence of these antibodies remains unknown, their presence throws new light on immunological disorders in rheumatoid arthritis.
mesh_terms: D000328:Adult; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D001323:Autoantibodies / Q000032:analysis; D005260:Female; D006801:Humans; D008875:Middle Aged; D009132:Muscles / Q000276:immunology; D009157:Myasthenia Gravis / Q000139:chemically induced* / Q000276:immunology; D010396:Penicillamine / Q000009:adverse effects* / Q000276:immunology; D011950:Receptors, Cholinergic / Q000276:immunology
chemical_list: D001323:Autoantibodies; D011950:Receptors, Cholinergic; D010396:Penicillamine
vernacular_title: Syndromes myasthéniques induits par la D-pénicillamine au cours de la polyarthrite rhumatoïde. Deux observations.