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[Acetylcholine receptor antibody in D-penicillamine therapy]

G Kolarz, E M Maida

    Zeitschrift Fur Rheumatologie
    |May 1, 1986
    PubMed

    Insights

    D-penicillamine (D-PA) treatment can lead to myasthenic syndrome by triggering anti-acetylcholine-receptor-antibodies (anti-AChR). Routine monitoring for anti-AChR in patients on D-PA may be warranted.

    Area of Science:

    • Rheumatology
    • Neurology
    • Immunology

    Background:

    • Rheumatoid arthritis patients often receive D-penicillamine (D-PA) for long-term management.
    • D-penicillamine is known to have various side effects, necessitating careful patient monitoring.

    Observation:

    • A patient on D-PA developed transient diplopia, followed by a myasthenic syndrome.
    • Anti-acetylcholine-receptor-antibodies (anti-AChR) were detected in the patient's serum, with evidence suggesting their presence predated clinical symptoms.

    Findings:

    • Anti-acetylcholine-receptor-antibodies (anti-AChR) were found in two out of 13 other rheumatoid arthritis patients receiving D-PA.
    • Electroneurological tests in these patients were normal, despite the presence of anti-AChR.

    Implications:

    • The findings suggest a potential link between D-penicillamine use and the development of anti-acetylcholine-receptor-antibodies (anti-AChR).
    • Routine screening for anti-AChR in patients undergoing long-term D-PA therapy might be beneficial for early detection and prevention of potential neurological complications.

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