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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.
Abstract:
We describe a 63-year-old female patient with rheumatoid arthritis who developed complete heart block and features of polymyositis within a few weeks of starting treatment with D-penicillamine. We believe she is one of only three published patients in whom complete heart block accompanies penicillamine-induced polymyositis. The literature on penicillamine myositis is reviewed with special emphasis on cardiac problems. Patients taking D-penicillamine who develop features suggestive of polymyositis may develop insidious, but potentially life-threatening cardiac involvement and must be carefully monitored.