PMID: 6535556Dec 1, 1984Paper

Myasthenia gravis induced by D-penicillamine in a patient with progressive systemic sclerosis

Arquivos de neuro-psiquiatria
P E MarchioriJ L De Assis

Abstract

The development of autoimmune diseases in some patients treated with D-penicillamine (DPA) suggests that the reported occurrence of a conduction disorder at the neuromuscular junction and the development of a reversible myasthenia gravis in rheumatoid disease, progressive systemic sclerosis or Wilson's disease after the use of DPA are part of a general predisposition for autoimmune disease related to DPA therapy. The case reported is an example. The DPA- induced myasthenia gravis (MG) is similar to the spontaneous MG clinically and electrophysiologically, though ocular signs prevail in the former. Antibodies to acetylcholine receptor have been demonstrated and thymic hyperplasia also has been formed. Regarding the onset of myasthenic manifestations the duration of the treatment with DPA varies from 6 to 10 months. The action of DPA on the neuromuscular junction is different from that occurring in spontaneous MG. The pathogenesis of the DPA induced MG is still obscure. The chemical properties of DPA permit it to react with many proteins and some alteration of proteins may appear, with structural changes in the composition and antigenicity of the collagen fibers. In vitro DPA causes disorder of acetylcholine receptor bridges to a...Continue Reading

References

Aug 1, 1976·British Heart Journal·M Muers, W Stokes
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Citations

Dec 1, 1987·Arquivos de neuro-psiquiatria·L C Werneck, H A Teive
Dec 1, 1993·Arquivos de neuro-psiquiatria·A L WerneckG Tuma
May 1, 1988·The American Journal of the Medical Sciences·J D Smiley, S E Moore

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