[D-penicillamine-induced myasthenia gravis].
D-penicillamine has been used in the treatment of rheumatoid arthritis for years. As a rare complication of this treatment the occurrence of myasthenia gravis has been described, the clinical features of this complication being indistinguishable from that of idiopathic myasthenia gravis. Both D-penicillamine induced and idiopathic myasthenia gravis show elevated titers of acetylcholine receptor antibodies and respond to acetylcholinesterase inhibitor treatment. We report on a patient with rheumatoid arthritis who, under treatment with D-penicillamine, developed severe myasthenia gravis which required temporary acetylcholinesterase inhibitor therapy. 8 months after D-penicillamine was discontinued the acetylcholine receptor antibodies had disappeared and the acetylcholinesterase inhibitors could be withdrawn. Clinical findings and possible pathogenetic aspects of D-penicillamine induced myasthenia gravis are discussed.
Frey
R A
RA
Rheumaklinik, Universitätsspital, Zürich.
Keller
F
F
Michel
B A
BA
D000368:Aged; D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D001323:Autoantibodies / Q000302:isolation & purification; D005260:Female; D006801:Humans; D009157:Myasthenia Gravis / Q000139:chemically induced* / Q000188:drug therapy / Q000276:immunology; D010396:Penicillamine / Q000009:adverse effects* / Q000627:therapeutic use; D011729:Pyridostigmine Bromide / Q000627:therapeutic use; D011950:Receptors, Cholinergic / Q000276:immunology
D001323:Autoantibodies; D011950:Receptors, Cholinergic; D010396:Penicillamine; D011729:Pyridostigmine Bromide
D-Penicillamin-induzierte Myasthenia gravis.