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. 1989 Dec;73(12):1015–1018. doi: 10.1136/bjo.73.12.1015

Ocular myasthenia gravis after D-penicillamine administration.

L J Katz 1, R L Lesser 1, J R Merikangas 1, J P Silverman 1
PMCID: PMC1041959  PMID: 2692700

Abstract

A 68-year-old black woman who was put on D-penicillamine therapy (250-500 mg per day, total dose 15 g) for rheumatoid arthritis developed ocular myasthenia gravis. Two weeks after she discontinued D-penicillamine her signs and symptoms cleared with no other treatment. Review of previous cases and possible immunological mechanisms are discussed.

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Selected References

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  1. Aldrich M. S., Kim Y. I., Sanders D. B. Effects of D-penicillamine on neuromuscular transmission in rats. Muscle Nerve. 1979 May-Jun;2(3):180–185. doi: 10.1002/mus.880020305. [DOI] [PubMed] [Google Scholar]
  2. Argov Z., Mastaglia F. L. Drug therapy: Disorders of neuromuscular transmission caused by drugs. N Engl J Med. 1979 Aug 23;301(8):409–413. doi: 10.1056/NEJM197908233010805. [DOI] [PubMed] [Google Scholar]
  3. Argov Z., Mastaglia F. L. Drug therapy: Disorders of neuromuscular transmission caused by drugs. N Engl J Med. 1979 Aug 23;301(8):409–413. doi: 10.1056/NEJM197908233010805. [DOI] [PubMed] [Google Scholar]
  4. Atcheson S. G., Ward J. R. Ptosis and weakness after start of D-penicillamine therapy. Ann Intern Med. 1978 Dec;89(6):939–940. doi: 10.7326/0003-4819-89-6-939. [DOI] [PubMed] [Google Scholar]
  5. Benveniste M., Crouzet J., Homberg J. C., Lessana M., Camus J. P., Hewitt J. Pemphigus induits par la D-pénicillamine dans la polyarthrite rhumatoïde. Etude de cinq cas et recherche systématique des anticorps antisubstances intercellulaires de l'épiderme au cours du traitement. Nouv Presse Med. 1975 Dec 20;4(44):3125–3128. [PubMed] [Google Scholar]
  6. Bever C. T., Jr, Chang H. W., Penn A. S., Jaffe I. A., Bock E. Penicillamine-induced myasthenia gravis: effects of penicillamine on acetylcholine receptor. Neurology. 1982 Oct;32(10):1077–1082. doi: 10.1212/wnl.32.10.1077. [DOI] [PubMed] [Google Scholar]
  7. Bocanegra T., Espinoza L. R., Vasey F. B., Germain B. F. Myasthenia gravis and penicillamine therapy of rheumatoid arthritis. JAMA. 1980 Oct 17;244(16):1822–1823. [PubMed] [Google Scholar]
  8. Bucknall R. C., Dixon A St J., Glick E. N., Woodland J., Zutshi D. W. Myasthenia gravis associated with penicillamine treatment for rheumatoid arthritis. Br Med J. 1975 Mar 15;1(5958):600–602. doi: 10.1136/bmj.1.5958.600. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. CRAWHALL J. C., SCOWEN E. F., WATTS R. W. Effect of penicillamine on cystinuria. Br Med J. 1963 Mar 2;1(5330):588–590. doi: 10.1136/bmj.1.5330.588. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Corrigan J. J., Jr, Kolba K. S., Gall E. P., Trombley J., Damiano M. L., Meredith K., Jeter M. Treatment of hemophilic arthritis with D-penicillamine: a preliminary report. Am J Hematol. 1985 Jul;19(3):255–264. doi: 10.1002/ajh.2830190307. [DOI] [PubMed] [Google Scholar]
  11. Epstein O., De Villiers D., Jain S., Potter B. J., Thomas H. C., Sherlock S. Reduction of immune complexes and immunoglobulins induced by D-penicillamine in primary biliary cirrhosis. N Engl J Med. 1979 Feb 8;300(6):274–278. doi: 10.1056/NEJM197902083000602. [DOI] [PubMed] [Google Scholar]
  12. Gordon R. A., Burnside J. W. D-Penicillamine-induced myasthenia gravis in rheumatoid arthritis. Ann Intern Med. 1977 Nov;87(5):578–579. doi: 10.7326/0003-4819-87-5-578. [DOI] [PubMed] [Google Scholar]
  13. Grahame-Smith D. G., Green A. R., Costain D. W. Mechanism of the antidepressant action of electroconvulsive therapy. Lancet. 1978 Feb 4;1(8058):254–257. doi: 10.1016/s0140-6736(78)90495-6. [DOI] [PubMed] [Google Scholar]
  14. Harpey J. P., Caille B., Moulias R., Goust J. M. Lupus-like syndrome induced by D-penicillamine in Wilson's disease. Lancet. 1971 Feb 6;1(7693):292–292. doi: 10.1016/s0140-6736(71)91022-1. [DOI] [PubMed] [Google Scholar]
  15. JAFFE I. A. Comparison of the effect of plasmapheresis and penicillamine on the level of circulating rheumatoid factor. Ann Rheum Dis. 1963 Mar;22:71–76. doi: 10.1136/ard.22.2.71. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Keesey J., Novom S. HLA antigens in pencillamine-induced myasthenia gravis. Neurology. 1979 Apr;29(4):528–529. doi: 10.1212/wnl.29.4.528-a. [DOI] [PubMed] [Google Scholar]
  17. LEE J. C., DUSHKIN M., EYRING E. J., ENGLEMAN E. P., HOPPER J., Jr RENAL LESIONS ASSOCIATED WITH GOLD THERAPY; LIGHT AND ELECTRON MICROSCOPIC STUDIES. Arthritis Rheum. 1965 Feb;8:1–13. doi: 10.1002/art.1780080102. [DOI] [PubMed] [Google Scholar]
  18. Masters C. L., Dawkins R. L., Zilko P. J., Simpson J. A., Leedman R. J. Penicillamine-associated myasthenia gravis, antiacetylcholine receptor and antistriational antibodies. Am J Med. 1977 Nov;63(5):689–694. doi: 10.1016/0002-9343(77)90153-x. [DOI] [PubMed] [Google Scholar]
  19. Merryman P., Jaffee I. A. Effect of penicillamine on the proliferative response of human lymphocytes. Proc Soc Exp Biol Med. 1978 Jan;157(1):155–158. doi: 10.3181/00379727-157-40011. [DOI] [PubMed] [Google Scholar]
  20. O'Keefe M., Morley K. D., Haining W. M., Smith A. Penicillamine-induced ocular myasthenia gravis. Am J Ophthalmol. 1985 Jan 15;99(1):66–67. doi: 10.1016/s0002-9394(14)75869-6. [DOI] [PubMed] [Google Scholar]
  21. Palferman T. G. Polymyalgia rheumatica and myasthenia gravis. J Rheumatol. 1981 Jan-Feb;8(1):169–171. [PubMed] [Google Scholar]
  22. Russell A. S., Lindstrom J. M. Penicillamine-induced myasthenia gravis associated with antibodies to acetylcholine receptor. Neurology. 1978 Aug;28(8):847–849. doi: 10.1212/wnl.28.8.847. [DOI] [PubMed] [Google Scholar]
  23. Schraeder P. L., Peters H. A., Dahl D. S. Polymyositis and penicillamine. Arch Neurol. 1972 Nov;27(5):456–457. doi: 10.1001/archneur.1972.00490170088013. [DOI] [PubMed] [Google Scholar]
  24. Sternlieb I., Bennett B., Scheinberg I. H. D-penicillamine induced Goodpasture's syndrome in Wilson's disease. Ann Intern Med. 1975 May;82(5):673–676. doi: 10.7326/0003-4819-82-5-673. [DOI] [PubMed] [Google Scholar]
  25. Sundstrom W. R., Schuna A. A. Penicillamine-induced myasthenia gravis. Arthritis Rheum. 1979 Feb;22(2):197–198. doi: 10.1002/art.1780220214. [DOI] [PubMed] [Google Scholar]
  26. WALSHE J. M. Penicillamine, a new oral therapy for Wilson's disease. Am J Med. 1956 Oct;21(4):487–495. doi: 10.1016/0002-9343(56)90066-3. [DOI] [PubMed] [Google Scholar]

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