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Related Experiment Videos

D-penicillamine induced polymyositis causing complete heart block

G D Wright1, C Wilson, A L Bell

  • 1Department of Rheumatology, Musgrave Park Hospital Green Park Healthcare trust, Belfast, Ireland, UK.

Clinical Rheumatology
|March 1, 1994
PubMed
Summary

D-penicillamine treatment for rheumatoid arthritis can cause polymyositis and complete heart block. This rare cardiac complication is potentially life-threatening and requires careful patient monitoring.

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Area of Science:

  • Rheumatology
  • Cardiology
  • Pharmacology

Background:

  • Rheumatoid arthritis (RA) is a chronic autoimmune disease.
  • D-penicillamine is a disease-modifying antirheumatic drug (DMARD) used in RA treatment.
  • Drug-induced polymyositis and cardiac complications are known adverse effects of certain medications.

Observation:

  • A 63-year-old female patient with RA developed complete heart block and polymyositis shortly after initiating D-penicillamine therapy.
  • This case represents a rare instance of concurrent complete heart block and D-penicillamine-induced polymyositis.

Findings:

  • The patient's presentation highlights a significant association between D-penicillamine use and severe cardiac and muscular adverse events.
  • Literature review indicates this combination of adverse effects is exceptionally uncommon, with few reported cases.

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  • Polymyositis induced by D-penicillamine can be associated with insidious and potentially fatal cardiac involvement.

    • Implications:

    • Physicians prescribing D-penicillamine, particularly for RA, must be vigilant for early signs of polymyositis.
    • Close cardiac monitoring is crucial in patients developing polymyositis symptoms while on D-penicillamine.
    • Prompt recognition and management are essential to mitigate the risk of life-threatening cardiac complications.