FOLLOW-UP INVESTIGATIONS AND IMMUNOLOGICA L FINDINGS IN DRUG-INDUCED MYASTHENIA

Patient and Method: We report 5 patients, who developed myasthenia, fo ur of them after treatment on D-penicillamine, one after treatment on chloroquine. 3 patients suffered from rheumatoid arthritis, one from a psoriatic arthritis and one from cirrhosis of the liver. Three patien ts developed an ocular myasthenia, one patient an oculopharyngeal and one patient has had generalized myasthenic syndrome. Results: Four pat ients showed an improvement of clinical status within days up to 18 mo nths following discontinuation of the therapy, whereas one patient det eriorated. The quickest improvement was observed in the patient with c hloroquine induced myasthenia. Four patients had raised acetylcholine- receptor antibody titers. The patient with chloroquine induced myasthe nia had had a normal acetylcholin-receptor antibody titer. The human l eucocyte antigen type was compared with the results of literature. Con clusion: To what extent human leucocyte antigen type HLA DR 4 has a co rrelation with the development of myasthenia following treatment on ch loroquine can not yet be answered with respect to the very small numbe r of cases at the moment.