Penicillamine-induced ocular myasthenia gravis in rheumatoid arthritis

We report a case of a 47-year-old woman with rheumatoid arthritis who developed ocular myasthenia gravis during penicillamine treatment. Her serum contained elevated titers of acetylcholine receptor antibodies, and her symptoms resolved 8 weeks after discontinuation of penicillamine. We review the clinical and laboratory features of this syndrome of penicillamine-induced myasthenia gravis and discuss its pathophysiology and treatment.