D-penicillamine induced myasthenia gravis. Its relevance for the anaesthetist.
نویسندگان
چکیده
The case of a 57-year-old woman with rheumatoid arthritis is presented to illustrate the rare occurrence of a myasthenic syndrome induced by D-penicillamine, which led to prolonged (5.25-h) postoperative apnoea necessitating artificial ventilation.
منابع مشابه
D-Penicillamine induced myasthenia gravis.
Myasthenia gravis is a disorder of impaired neuromuscular transmission resulting in weakness and abnormal fatigability on exertion, improved by anti-acetyl cholinesterase drugs. A number of drugs are known to exacerbate myasthenia gravis or interfere with neuromuscular transmission. We report a case of D-penicillamine induced myasthenia gravis who developed ptosis, diplopia and easy fatigabilit...
متن کاملHLA antigens and acetylcholine receptor antibodies in penicillamine induced myasthenia gravis.
Antibodies to the acetylcholine receptor and HLA antigens have been studied in patients with myasthenia gravis occurring in association with penicillamine treatment. The properties of the antiacetylcholine receptor in these patients differed from those in patients with idiopathic myasthenia gravis in terms of specificity and affinity. These patients had an increased prevalence of HLA Bw35 and D...
متن کاملD-penicillamine Induced Myasthenia Gravis
Rheumatoid arthritis can be a very mutilating disease and, as a result, the likelihood of patients with rheumatoid arthritis requiring surgery and anaesthesia is increased. D-penicillamine (D-Pen) has been used in the treatment of rheumatoid arthritis and Wilson's disease since the early 1960s. Its true mode of action is unknown, but it appears to modify the immune response. Treatment with D-Pe...
متن کاملOcular myasthenia gravis after D-penicillamine administration.
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.
متن کاملDrug-induced myasthenic syndromes
Drug-induced myasthenic syndromes are caused by numerous medications of various classes. D-penicillamine and interferon alpha lead to an autoimmune process similar to spontaneous myasthenia gravis, whereas many other agents produce weakness by a direct compromise of neuromuscular transmission. A particular problem in clinical practice is the deterioration of neuromuscular transmission by anesth...
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ورودعنوان ژورنال:
- British journal of anaesthesia
دوره 58 10 شماره
صفحات -
تاریخ انتشار 1986