Department of Neurology, National Neuro Center, Maharajgunj, Chakrapath, Kathmandu, Nepal.
KIST Medical College and Teaching Hospital, Imadol, Lalitpur, Nepal.
JNMA J Nepal Med Assoc. 2022 Jul 1;60(251):644-647. doi: 10.31729/jnma.7607.
Myasthenia gravis is a neuromuscular junction disorder characterised by fluctuating muscle weakness, improved by using anti-cholinesterase drugs. In addition to the autoimmune aetiology, various factors such as infections, surgery, and drugs are known to precipitate the condition. We report a case of a 15-year-old boy with D-penicillamine-induced myasthenia gravis who presented with facial diplegia, dysphagia, and drooling of saliva, 6 years after the initiation of treatment for Wilson's disease. Therefore, clinicians should be more vigilant while prescribing patients with chelating drugs like D-penicillamine with regular monitoring of the new symptoms and keeping a very low threshold for the suspicion of myasthenia gravis.
d-penicillamine; myasthenia gravis; pyridostigmine; Wilson's disease.
重症肌无力是一种神经肌肉接头疾病，其特征是肌肉无力波动，使用抗胆碱酯酶药物可改善。除了自身免疫病因外，还已知各种因素，如感染、手术和药物，可引发该病症。我们报告了一例 15 岁男孩的病例，他在开始治疗威尔逊病 6 年后因双巯丁二酸引起重症肌无力而出现面瘫、吞咽困难和流口水。因此，临床医生在为接受螯合药物（如双巯丁二酸）治疗的患者开具处方时应更加警惕，定期监测新症状，并对重症肌无力的怀疑保持非常低的阈值。
双巯丁二酸；重症肌无力；吡啶斯的明；威尔逊病。
