[Myasthenia induced by D-penicillamine. Study of immuno-clinical correlations in 23 cases]

Sera from 23 patients with D-penicillamine-induced myasthenia gravis (MG) contained antibodies directed against the human muscle acetylcholine receptor (anti-AChR) in 83% of the cases at the onset of the disease. Twenty-one were patients with rheumatoid arthritis. The anti-AChR antibody titers were comparable to those of sera from ocular MG patients and were related to the presence of clinical signs but not to their severity. The anti-AChR antibodies persisted in autonomous MG (5 cases) and disappeared in the other cases. The same phenomenon occurred for antinuclear antibodies detected in sera from 13 patients at the onset of the disease: anti-ss DNA 9/13, antinuclear 4/13 and anti-histones 7/13. The latter antibodies seem to result from, and follow the D-penicillamine treatment.