D-penicillamine induced myasthenia gravis: clinical, serological and genetic findings

Eight cases of D-penicillamine (DP) induced myasthenia gravis (MG) are presented. Seven patients were being treated for rheumatoid arthritis (RA) and one for scleroderma. The mean duration of DP treatment until the myasthenic symptoms developed ranged from 2-8 months. The DP dose reached 500 mg dail...

Full description

Saved in:
Bibliographic Details
Published inClinical and experimental rheumatology Vol. 11; no. 4; p. 387
Main Authors Drosos, A A, Christou, L, Galanopoulou, V, Tzioufas, A G, Tsiakou, E K
Format Journal Article
LanguageEnglish
Published Italy 01.07.1993
Subjects
Adult
Arthritis, Rheumatoid - drug therapy
Autoantibodies - blood
Female
HLA-DR Antigens - genetics
Humans
Immunogenetics
Male
Middle Aged
Myasthenia Gravis - chemically induced
Myasthenia Gravis - genetics
Myasthenia Gravis - immunology
Penicillamine - adverse effects
Receptors, Cholinergic - immunology
Scleroderma, Systemic - drug therapy
Online AccessGet more information

Cover

More Information
Summary:Eight cases of D-penicillamine (DP) induced myasthenia gravis (MG) are presented. Seven patients were being treated for rheumatoid arthritis (RA) and one for scleroderma. The mean duration of DP treatment until the myasthenic symptoms developed ranged from 2-8 months. The DP dose reached 500 mg daily. It was found that the clinical and immunological findings were almost similar to those of idiopathic MG, but were less severe. All patients had increased titers of acetylcholine receptor antibodies in their sera. Discontinuation of D-penicillamine resulted in the complete resolution of myasthenic symptoms after 2-6 months. One patient required ventilation, immunosuppressive therapy and plasma exchange. No association was found between DP related MG and the various autoantibodies tested. Immunogenetic analysis showed that three patients had HLA-DR1, two HLA-DR3, one HLA-DR4 and one HLA-DR5. In conclusion, the clinical presentation of DP-induced MG seems similar to idiopathic MG. DP-related MG is relatively benign, although it sometimes can cause life-threatening muscle weakness requiring aggressive therapy. The relatively small number of patients included in this study, however, does not permit any firm conclusions regarding the HLA associations of DP-related MG.
ISSN:0392-856X