Seitz D, Hopf H C, Janzen R W, Meyer W
Dtsch Med Wochenschr. 1976 Jul 30;101(31):1153-8. doi: 10.1055/s-0028-1104232.
A myasthenic reaction developed after an average latency of seven to eight months in 12 female patients (average age 51 years) treated with penicillamine for chronic rheumatoid arthritis. In most of them only the purely ocular form was noted, but generalisation of various degrees also occurred. When penicillamine had been discontinued the myasthenic signs were almost always fully reversible, recurring once again when treatment with penicillamine was started. In some instances a transitory symptomatic treatment with cholinesterase inhibitors was necessary. The occurrence of the myasthenic signs in these circumstances is probably similar to the anti-basal membrane nephropathy induced by penicillamine.
12名接受青霉胺治疗慢性类风湿性关节炎的女性患者（平均年龄51岁），在平均7至8个月的潜伏期后出现了重症肌无力反应。其中大多数仅表现为单纯眼肌型，但也出现了不同程度的全身症状。停用青霉胺后，重症肌无力体征几乎总是完全可逆的，再次开始使用青霉胺治疗时会再次出现。在某些情况下，需要用胆碱酯酶抑制剂进行短暂的对症治疗。在这些情况下出现重症肌无力体征，可能与青霉胺诱发的抗基底膜肾病类似。
