title: D-penicillamine induced polymyositis causing complete heart block.
abstract: We describe a 63-year-old female patient with rheumatoid arthritis who developed complete heart block and features of polymyositis within a few weeks of starting treatment with D-penicillamine. We believe she is one of only three published patients in whom complete heart block accompanies penicillamine-induced polymyositis. The literature on penicillamine myositis is reviewed with special emphasis on cardiac problems. Patients taking D-penicillamine who develop features suggestive of polymyositis may develop insidious, but potentially life-threatening cardiac involvement and must be carefully monitored.
authors.affiliation: Department of Rheumatology, Musgrave Park Hospital Green Park Healthcare trust, Belfast, Ireland, UK.
authors.forename: G D
authors.initials: GD
authors.lastname: Wright
authors.forename: C
authors.initials: C
authors.lastname: Wilson
authors.forename: A L
authors.initials: AL
authors.lastname: Bell
mesh_terms: D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D003165:Complement System Proteins / Q000032:analysis; D005260:Female; D006327:Heart Block / Q000209:etiology*; D006801:Humans; D007136:Immunoglobulins / Q000097:blood; D008875:Middle Aged; D010396:Penicillamine / Q000009:adverse effects* / Q000627:therapeutic use; D017285:Polymyositis / Q000139:chemically induced* / Q000150:complications*
chemical_list: D007136:Immunoglobulins; D003165:Complement System Proteins; D010396:Penicillamine