D-penicillamine Induced Myasthenia Gravis in Wilson’s Disease: A Case Report

Authors

  • Lekhjung Thapa Department of Neurology, National Neuro Center, Maharajgunj, Chakrapath, Kathmandu, Nepal
  • Monika Thapa Department of Neurology, National Neuro Center, Maharajgunj, Chakrapath, Kathmandu, Nepal
  • Suman Bhattarai Department of Neurology, National Neuro Center, Maharajgunj, Chakrapath, Kathmandu, Nepal
  • Abhishek Man Shrestha Department of Neurology, National Neuro Center, Maharajgunj, Chakrapath, Kathmandu, Nepal
  • Nooma Sharma Department of Neurology, National Neuro Center, Maharajgunj, Chakrapath, Kathmandu, Nepal
  • Nilshan Rai KIST Medical College and Teaching Hospital, Imadol, Lalitpur, Nepal
  • Merina Pokharel Department of Neurology, National Neuro Center, Maharajgunj, Chakrapath, Kathmandu, Nepal
  • Raju Paudel Department of Neurology, National Neuro Center, Maharajgunj, Chakrapath, Kathmandu, Nepal

DOI:

https://doi.org/10.31729/jnma.7607

Keywords:

d-penicillamine; myasthenia gravis; pyridostigmine; Wilson's disease.

Abstract

Myasthenia gravis is a neuromuscular junction disorder characterised by fluctuating muscle weakness, improved by using anti-cholinesterase drugs. In addition to the autoimmune aetiology, various factors such as infections, surgery, and drugs are known to precipitate the condition. We report a case of a 15-year-old boy with D-penicillamine-induced myasthenia gravis who presented with facial diplegia, dysphagia, and drooling of saliva, 6 years after the initiation of treatment for Wilson’s disease. Therefore, clinicians should be more vigilant while prescribing patients with chelating drugs like D-penicillamine with regular monitoring of the new symptoms and keeping a very low threshold for the suspicion of myasthenia gravis.

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Published

2022-07-01

How to Cite

Thapa, L., Thapa, M., Bhattarai, S., Shrestha, A. M., Sharma, N., Rai, N., Pokharel, M., & Paudel, R. (2022). D-penicillamine Induced Myasthenia Gravis in Wilson’s Disease: A Case Report. Journal of Nepal Medical Association, 60(251), 644–647. https://doi.org/10.31729/jnma.7607

Issue

Vol. 60 No. 251 (2022): JNMA: Published Monthly

Section

Case Reports

License

Copyright (c) 2022 Lekhjung Thapa, Monika Thapa, Suman Bhattarai, Abhishek Man Shrestha, Nooma Sharma, Nilshan Rai, Merina Pokharel, Raju Paudel

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