[Myasthenia syndrome after peroral treatment with penicillamine]

A 59-year-old woman has been treated for 5 months with penicillamine for a rheumatoid arthritis and developed a myasthenia syndrome with ptosis, diplopia, dysphagia and asthenia. This myasthenia was slowly cured after suppression of the penicillamine and administration of Mestinon, so that after 3 months, the anticholinesterase medication could be stopped.