D-penicillamine and gold salt treatments were complicated by myasthenia and pemphigus, respectively, in the same patient with rheumatoid arthritis.
A 53-year-old woman with rheumatoid arthritis developed myasthenia gravis after 6 months of therapy with D-penicillamine. Nineteen months after D-penicillamine was discontinued and 12 months after the beginning of gold therapy, she developed pemphigus vulgaris. This is the first reported case of gold-induced pemphigus in rheumatoid arthritis. This study further underlines the complex interactions between the effects of treatment with sulfhydryl-disulfide exchange drugs and the altered immunological system of patients affected by rheumatoid arthritis.
Ciompi
M L
ML
Rheumatic Disease Unit, University of Pisa, Italy.
Marchetti
G
G
Bazzichi
L
L
Puccetti
L
L
Agelli
M
M
D018501:Antirheumatic Agents / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000276:immunology; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000139:chemically induced*; D050607:Organogold Compounds; D010392:Pemphigus / Q000139:chemically induced*; D010396:Penicillamine / Q000009:adverse effects*
D018501:Antirheumatic Agents; D050607:Organogold Compounds; D010396:Penicillamine