What is drug induced autoimmune Myasthenia gravis?
Approximately 1% of patients taking d -penicillamine for the treatment of diseases such as rheumatoid arthritis or Wilson’s disease develop clinical myasthenia.
The disease is six times more common in women, first striking the ocular muscles and then becoming generalized.
Patients have autoantibodies against AChRs, which usually slowly disappear (along with Myasthenia gravis symptoms) after discontinuation of the drug.
Trimethadione, an anticonvulsant, also may induce myasthenia.
These patients have high titers of antimuscle antibodies and antinuclear factor, and symptoms suggestive of systemic lupus erythematosus.
