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D-penicillamine-associated myasthenia gravis: Immunological and electrophysiological studies

Fawcett, P.R.W., McLachlan, S.M., Nicholson, L.V.B., Argov, Z. and Mastaglia, F.L. (1982) D-penicillamine-associated myasthenia gravis: Immunological and electrophysiological studies. Muscle & Nerve, 5 (4). pp. 328-334.

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Immunological and electrophysiological features were investigated in a patient with rheumatoid arthritis who developed myasthenic symptoms after 10 months of treatment with D-penicillamine (D-pen). After an initial rise, acetylcholine receptor (AChR) antibodies gradually fell from 24.4 nmole α-bungarotoxin bound/liter to 1.8 nmole/liter following withdrawal of the drug, and this was associated with clinical and electrophysiological improvement. Immunoglobulin synthesis by peripheral blood lymphocytes cultured with pokeweed mitogen and D-pen was significantly increased at D-pen concentrations of 10–100 μg/ml in 2 patients with D-pen associated myasthenia gravis and 1 out of 3 normal individuals. Furthermore, lymphocytes from 1 myasthenic patient synthesized detactable AChR antibodies in vitro, and the amount of receptor antibody produced was increased in the presence of the drug. This effect was most marked at a concentration of 10 μg/ml which is thought to approximate the concentration in vivo. Our results confirm the in vivo findings of others that D-pen may have different effects on immunoglobulin production in different individuals and may also enhance the synthesis of at least 1 autoantibody, the AChR antibody.

Item Type: Journal Article
Publisher: John Wiley and Sons Inc.
Copyright: © 1982 John Wiley & Sons, Inc.
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