Adelman H M, Winters P R, Mahan C S, Wallach P M
Department of Internal Medicine, University of South Florida, College of Medicine, Tampa 33612.
Am J Med Sci. 1995 Apr;309(4):191-3. doi: 10.1097/00000441-199504000-00001.
D-penicillamine, a drug used to treat rheumatoid arthritis, Wilson's disease, and cystinuria, can cause myasthenia gravis. Fortunately, the myasthenia typically resolves after discontinuation of the drug. The diagnosis may be missed if weakness is blamed on a patient's underlying disease(s), in particular, rheumatoid arthritis. Reported here are the cases of two patients with chronic obstructive lung disease who were taking D-penicillamine for rheumatoid arthritis, then experienced increasing respiratory failure. At first, their problem seemed to stem from chronic lung disease, but further evaluation revealed the cause of the hypoventilation to be D-penicillamine-induced myasthenia gravis.
青霉胺是一种用于治疗类风湿性关节炎、威尔逊氏病和胱氨酸尿症的药物，可导致重症肌无力。幸运的是，重症肌无力通常在停药后会缓解。如果将肌无力归咎于患者的基础疾病，尤其是类风湿性关节炎，可能会漏诊。本文报告了两名慢性阻塞性肺疾病患者的病例，他们因类风湿性关节炎服用青霉胺，随后出现进行性呼吸衰竭。起初，他们的问题似乎源于慢性肺病，但进一步评估发现通气不足的原因是青霉胺诱发的重症肌无力。
