D-penicillamine-induced myositis in rheumatoid arthritis.
D-penicillamine, an agent still used in the treatment of rheumatoid arthritis (RA) may produce inflammatory myopathy or myositis. Some reported cases are documented with muscle biopsy. We report a 34-year old female, receiving the drug for more than 4 years, who consulted us with recently developed proximal muscle pain and weakness. EMG-findings were typical for inflammatory muscle disease; muscle enzymes remained normal. D-penicillamine was stopped and she was started on prednisolone with rapid improvement. The EMG-findings, with follow-up within three months, proved to be a good diagnostic tool, in the absence of laboratory muscle enzymes abnormalities.
Chappel
R
R
Department of Physical Medicine and Rheumatology, Middelheim Hospital, Antwerp, Belgium.
Willems
J
J
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D001707:Biopsy, Needle; D004576:Electromyography; D005260:Female; D006801:Humans; D009220:Myositis / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D010396:Penicillamine / Q000009:adverse effects* / Q000627:therapeutic use; D011239:Prednisolone / Q000627:therapeutic use
D000893:Anti-Inflammatory Agents; D018501:Antirheumatic Agents; D011239:Prednisolone; D010396:Penicillamine