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D-penicillamine Induced Myasthenia Gravis in Wilson's Disease: A Case Report
Lekhjung Thapa1, Monika Thapa1, Suman Bhattarai1
1Department of Neurology, National Neuro Center, Maharajgunj, Chakrapath, Kathmandu, Nepal.
Abstract:
Myasthenia gravis is a neuromuscular junction disorder characterised by fluctuating muscle weakness, improved by using anti-cholinesterase drugs. In addition to the autoimmune aetiology, various factors such as infections, surgery, and drugs are known to precipitate the condition. We report a case of a 15-year-old boy with D-penicillamine-induced myasthenia gravis who presented with facial diplegia, dysphagia, and drooling of saliva, 6 years after the initiation of treatment for Wilson's disease. Therefore, clinicians should be more vigilant while prescribing patients with chelating drugs like D-penicillamine with regular monitoring of the new symptoms and keeping a very low threshold for the suspicion of myasthenia gravis.
Keywords:
d-penicillamine; myasthenia gravis; pyridostigmine; Wilson's disease.
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