[Myasthenic syndrome during penicillamine treatment (author's transl)]

The clinical and electrophysiological findings in 2 men who had developed a myasthenic syndrome after taking penicillamine for rheumatoid arthritis will be described. The symptoms began with dysfunction of the eye muscles following a generalised muscle weakness. Course of illness after withdrawal of penicillamine was not uniform. In one of the patients a complete remission occurred within a year. The other became steadily worse and required continuous treatment with cholinesterase inhibitors. Electrophysiological examinations showed neuromuscular blockade, posttetanic exhaustion, posttetanic potentiation was found in one patient only. An immunopharmacological block of acetylcholine receptors induced by penicillamine is discussed from a pathogenetical point of view.