PATIENT AND METHOD: We report 5 patients, who developed myasthenia, four 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 patients developed an ocular myasthenia, one patient an oculopharyngeal and one patient has had generalized myasthenic syndrome. RESULTS: Four patients showed an improvement of clinical status within days up to 18 months following discontinuation of the therapy, whereas one patient deteriorated. The quickest improvement was observed in the patient with chloroquine induced myasthenia. Four patients had raised acetylcholine-receptor antibody titers. The patient with chloroquine induced myasthenia had had a normal acetylcholin-receptor antibody titer. The human leucocyte antigen type was compared with the results of literature. CONCLUSION: To what extent human leucocyte antigen type HLA DR 4 has a correlation with the development of myasthenia following treatment on chloroquine can not yet be answered with respect to the very small number of cases at the moment.
PATIENT AND METHOD: We report 5 patients, who developed myasthenia, four 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 patients developed an ocular myasthenia, one patient an oculopharyngeal and one patient has had generalized myasthenic syndrome. RESULTS: Four patients showed an improvement of clinical status within days up to 18 months following discontinuation of the therapy, whereas one patient deteriorated. The quickest improvement was observed in the patient with chloroquine induced myasthenia. Four patients had raised acetylcholine-receptor antibody titers. The patient with chloroquine induced myasthenia had had a normal acetylcholin-receptor antibody titer. The human leucocyte antigen type was compared with the results of literature. CONCLUSION: To what extent human leucocyte antigen type HLA DR 4 has a correlation with the development of myasthenia following treatment on chloroquine can not yet be answered with respect to the very small number of cases at the moment.