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Case report identifies D-penicillamine as a trigger for myasthenia gravis, highlighting autoimmune implications in patients.
D-Penicillamine (DPA) is a chelating agent widely used for Wilson’s disease, with Myasthenia gravis (MG) reported in approximately 1–7% of treated patients. The proposed mechanism involves immune dysregulation through modification of histocompatibility complex (MHC) molecules, triggering autoimmunity against acetylcholine receptors. DPA–induced MG may occur months to years (6–96 months) after therapy initiation, particularly in Wilson’s Disease patients, and often presents with isolated ocular symptoms with good response to pyridostigmine and clinical remission within one year after DPA treatment cessation.
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Shah et al. (2026) studied this question.
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