Autoantibodies in d-penicillamine-induced myasthenia gravis: A comparison with idiopathic myasthenia and rheumatoid arthritis

• Published in: Clinical immunology and immunopathology Vol. 58; no. 3; pp. 318 - 330
• Main Authors: Morel, E., Feuillet-Fieux, M.N., Vernet-der Garabedian, B., Raimond, F., D'Anglejan, J., Bataille, R., Sany, J., Bach, J.F.
• Format: Journal Article
• Language: English
• Published: San Diego, CA Elsevier Inc 01.03.1991; New York, NY Academic Press; Boston
• Subjects: Adult; Aged; Antibodies, Antinuclear - analysis; Arthritis, Rheumatoid - complications; Arthritis, Rheumatoid - drug therapy; Arthritis, Rheumatoid - immunology; Autoantibodies - analysis; Biological and medical sciences; Diseases of the osteoarticular system; Enzyme-Linked Immunosorbent Assay; Female; Fluorescent Antibody Technique; Humans; Inflammatory joint diseases; Male; Medical sciences; Middle Aged; Myasthenia Gravis - etiology; Myasthenia Gravis - immunology; Penicillamine - adverse effects; Penicillamine - immunology; Receptors, Cholinergic - immunology; Human; Immunopathology; Specificity; Nervous system diseases; Myasthenia gravis; Rheumatoid arthritis; Diseases of the osteoarticular system; Autoantibody; Autoimmune disease; Inflammatory joint disease; Comparative study
• ISSN: 0090-1229; 1090-2341
• DOI: 10.1016/0090-1229(91)90123-R

The distribution of autoantibodies was studied in patients with rheumatoid arthritis (RA) treated by d-penicillamine and who developed myasthenia gravis (MG). The anti-human acetylcholine receptor (AChR) antibodies were specifically associated with clinical symptoms of MG without any difference in the pattern of specificities in idiopathic (id-MG) or in induced MG (DPen-MG). Conversely, anti-nuclear antibodies were elevated in DPen-MG sera compared to id-MG sera ( P < 0.001) but were also compared to patients with RA treated by d-penicillamine (or thiopronine) and who did not develop MG. Anti-denatured DNA antibodies were enhanced in sera from treated patients, whether they had presented or not a MG disease. Anti-histone antibodies were associated with RA. These observations suggest that the immunological imbalance in RA patients, can be increased by a drug treatment which may trigger the appearance of a second autoimmune disease such as MG, where anti-AChR antibodies are associated with anti-nuclear antibodies.