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Fatal Polymyositis in D-Penicillamine-Treated Rheumatoid Arthritis

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▸Requests for reprints should be addressed to Deborah R. Doyle, M.D.; B-3223 Medical Center North, Vanderbilt University, 21st Avenue South; Nashville, TN 37232.

Nashville, Tennessee

© 1983 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1983;98(3):327-330. doi:10.7326/0003-4819-98-3-327
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Thirteen reports of patients who developed polymyositis or dermatomyositis during treatment with D-penicillamine are reviewed and a fourteenth case is described. Twelve of the fourteen patients recovered after D-penicillamine was withdrawn; two patients died from cardiac involvement. Proximal muscle weakness was present in 13 patients and dermatomyositis in 4 patients. Dysphagia was the presenting symptom in 6 patients. Although D-penicillamine is useful in the management of rheumatoid arthritis, this drug should be used with caution and patients monitored closely for evidence of polymyositis or dermatomyositis.





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