D-PENICILLAMINE-INDUCED MYOSITIS IN RHEUMATOID-ARTHRITIS

D-penicillamine, an agent still used in the treatment of rheumatoid ar thritis (RA) may produce inflammatory myopathy or myositis, Some repor ted cases are documented with muscle biopsy. We report a 34-year old f emale, receiving the drug for more than 3 years, who consulted us with recently developed proximal muscle pain and weakness. EMG-findings we re typical for inflammatory muscle disease; muscle enzymes remained no rmal. D-penicillamine was stopped and she was started on prednisolone with rapid improvement. The EMG-findings, with follow-up within three months, proved to be a good diagnostic tool, in the absence of laborat ory muscle enzymes abnormalities.