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Penicillamine-Induced Neuropathy in Rheumatoid Arthritis

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▸Requests for reprints should be addressed to Howard Feit, M.D., Ph.D.; University of Texas Health Science Center, 5323 Harry Hines Boulevard; Dallas, TX 75235.

University of Texas Health Science Center; Dallas, Texas.

Ann Intern Med. 1981;95(4):457-458. doi:10.7326/0003-4819-95-4-457
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D-penicillamine, a known pyridoxine antagonist (1, 2), is being used with increasing frequency in the treatment of rheumatoid arthritis (3-5). We report here an adverse reaction, a profound sensory and motor neuropathy that responded to the addition of pyridoxine. Because neurologic dysfunction in patients with rheumatoid arthritis can occur as a result of several different forms of peripheral neuropathy the recognition of penicillamine-induced neuropathy may be difficult in these patients and is easily prevented with the use of pyridoxine.

A 55-year-old white woman had a long history of seronegative erosive anodular rheumatoid arthritis. She had sustained involvement of all major


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