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Diffuse fasciculations induced by D-penicillamine
The Journal of Rheumatology
|October 1, 1983
Abstract:
Diffuse fasciculations developed in a patient with rheumatoid arthritis who had received D-penicillamine for 6 months. Fasciculations disappeared after discontinuation of the drug but recurred on rechallenge. This reversible neuromuscular irritability has been reported with gold therapy but not with D-penicillamine.
Insights
D-penicillamine, a drug used for rheumatoid arthritis, can cause reversible neuromuscular irritability like fasciculations. These symptoms resolved upon drug cessation and reappeared with reintroduction.
Area of Science:
- Neurology
- Rheumatology
- Pharmacology
Background:
- Rheumatoid arthritis (RA) is a chronic autoimmune disease.
- RA treatment often involves disease-modifying antirheumatic drugs (DMARDs).
- Gold salts and D-penicillamine are DMARDs with known side effects.
Observation:
- A patient with RA developed diffuse fasciculations after 6 months of D-penicillamine treatment.
- The fasciculations resolved after discontinuing D-penicillamine.
- Symptoms recurred upon rechallenge with D-penicillamine.
Findings:
- D-penicillamine can induce reversible neuromuscular irritability.
- This adverse effect, characterized by fasciculations, has not been previously documented for D-penicillamine.
- The pattern suggests a drug-induced phenomenon.
Implications:
- Clinicians should consider D-penicillamine as a potential cause of fasciculations in RA patients.
- This finding expands the known side effect profile of D-penicillamine.
- Further investigation into the mechanism of D-penicillamine-induced neuromuscular irritability is warranted.