Penicillamine –Associated Myasthenia Presenting as Respiratory Failure

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Muhammad Hafizullah
J.P. Delamme
G.E Packe
C.W.F. Clarke


A classical Rheumatoid arthritis patient having Penicillamine developed serve breathless and generalized muscle weakness. A Ch R anibodies supported the diagnosis of Penicillamine-associated Myasthenia. The patient is reported as he had some atypical features: 1. respiratory failure as a presenting feature is rare 2. major clinical feature of ocular symptoms were absent 3. No definite response to anticholinesterase agents and 4. plasma exchange resulted in a decrease in A Ch R antibodies but there was no associated clinical response.

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Hafizullah M, Delamme J, Packe G, Clarke C. Penicillamine –Associated Myasthenia Presenting as Respiratory Failure. J Postgrad Med Inst [Internet]. 2011 Aug. 19 [cited 2023 Dec. 1];1(1). Available from:
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