D-PENICILLAMINE INDUCED MYASTHENIA-GRAVIS IN RHEUMATOID-ARTHRITIS - AN UNPREDICTABLE COMMON OCCURRENCE

被引：13

作者：

ANDONOPOULOS, AP

TERZIS, E

TSIBRI, E

PAPASTERIADES, CA

PAPAPETROPOULOS, T

机构：

[1] Department of Medicine, Patras University School of Medicine, Patras

[2] Department of Neurology, Patras University School of Medicine, Patras

[3] Immunology Laboratory, Evangelismos Hospital, Athens

来源：

CLINICAL RHEUMATOLOGY | 1994年 / 13卷 / 04期

关键词：

D-PENICILLAMINE; MYASTHENIA GRAVIS; RHEUMATOID ARTHRITIS; ANTIACETYLCHOLINE RECEPTOR ANTIBODIES; ANTI-RO(SSA) ANTIBODIES; HLA-DR1;

D O I：

10.1007/BF02242998

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Five patients out of 71 with rheumatoid arthritis (RA), who received D-penicillamine, developed myasthenia gravis (MG) within a two-year period. They all responded promptly to discontinuation of the drug and pyridostigmine administration. None of the patients had anti-Ro (SSA) antibodies or features of Sjogren's syndrome, whereas three of the five had the HLA-DR1 phenotype. The relatively high frequency of MG observed in our population, along with its unpredictability and potentially serious sequelae, necessitates its inclusion in the list of side effects of D-penicillamine routinely discussed with the patient, prior to initiation of the treatment. Full alertness of both the patient and the physician to even minor initial myasthenic symptoms, that dictate immediate discontinuation of the drug, is of obvious importance.

引用

页码：586 / 588

页数：3

共 24 条

[1]

Bucknall C., Myasthenia associated with D-penicillamine therapy in rheumatoid arthritis, Proc R Soc Med, 70, pp. 114-117, (1977)

[2]

Albers J.W., Hodach R.J., Kimmel D.W., Treacey W.L., Penicillamine associated myasthenia gravis, Neurology, 30, pp. 1246-1250, (1980)

[3]

Torres C.F., Griggs R.C., Baum J., Penn A.S., Penicillamine induced myasthenia gravis in progressive systemic sclerosis, Arthritis Rheum, 23, pp. 505-508, (1980)

[4]

Bever C.T., Chang H.W., Penn A.S., Jaffe I.A., Bock E., Penicillamine induced myasthenia gravis. Effects of penicillamine on acetylcholine receptor, Neurology, 32, pp. 1077-1082, (1982)

[5]

Garlepp M.J., Dawkins R.L., Christiansen F.T., HLA antigens and acetylcholine receptor antibodies in penicillamine induced myasthenia gravis, Br Med J, 286, pp. 338-340, (1983)

[6]

Delamere J.P., Jobson S., Mackintosh L.P., Wells L., Walton K.W., Penicillamine induced myasthenia in rheumatoid arthritis: its clinical and genetic features, Ann Rheum Dis, 42, pp. 500-504, (1983)

[7]

Benvenista M., Crouzet J., Hombert J.C., Lessana M., Camus J.P., Hewitt J., Pemphigus induits par la D-penicillamine dans la polyarthrite rheumatoide, Nouv Presse Med, 4, pp. 3125-3128, (1975)

[8]

Chalmers A., Thompson D., Stein H.E., Reid G., Patterson A.C., Systemic lupus erythematosus during penicillamine therapy for rheumatoid arthritis, Ann Intern Med, 97, pp. 659-663, (1982)

[9]

Morgan G.J., McGuire J.L., Ochoa J., Penicillamine induced myositis in rheumatoid arthritis, Muscle Nerve, 4, pp. 137-140, (1981)

[10]

Stenlieb I., Bennet B., Scheinberg I.H., D-penicillamine induced Goodpasture's syndrome in Wilson's disease, Ann Intern Med, 82, pp. 673-676, (1975)

← 1 2 3 →