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A case of polymyositis in a patient with primary biliary cirrhosis treated with D-penicillamine
1Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Abstract:
Although D-penicillamine has been used for many rheumatologic diseases, toxicity limits its usefulness in many patients. Polymyositis/dermatomyositis can develop as one of the autoimmune complications of D-penicillamine treatment, but its exact pathogenesis remains unclear. We report a patient with primary biliary cirrhosis, who developed polymyositis while receiving D-penicillamine therapy. We described the special clinical course of the patient. Patients receiving D-penicillamine therapy should be followed carefully for the development of autoimmune complications like polymyositis/dermatomyositis.
Insights
D-penicillamine, used for rheumatologic diseases, can cause autoimmune complications like polymyositis/dermatomyositis. Careful monitoring of patients on D-penicillamine therapy is crucial for early detection of these adverse effects.
Area of Science:
- Rheumatology
- Autoimmunology
- Pharmacology
Background:
- D-penicillamine is a chelating agent used to treat various rheumatologic conditions.
- Toxicity is a significant limitation to D-penicillamine's clinical utility.
- Autoimmune complications, including polymyositis/dermatomyositis, can arise during D-penicillamine treatment.
Observation:
- A case of primary biliary cirrhosis is presented.
- The patient developed polymyositis during D-penicillamine therapy.
- The unique clinical progression of this case is detailed.
Findings:
- D-penicillamine treatment can precipitate polymyositis/dermatomyositis.
- The pathogenesis of D-penicillamine-induced polymyositis/dermatomyositis requires further elucidation.
- This case highlights a potential autoimmune adverse effect of D-penicillamine.
Implications:
- Healthcare providers should vigilantly monitor patients undergoing D-penicillamine therapy.
- Awareness of potential autoimmune complications like polymyositis/dermatomyositis is essential.
- This underscores the need for careful risk-benefit assessment in D-penicillamine treatment.