Summary
Three patients receiving gold salt treatment for rheumatoid arthritis devel oped severe aplastic anemia. All three patients experienced remission of their disease at the time of the occurrence of marrow aplasia. Reviewing data on these patients and recen literature indicate that fatal marrow aplasia seems to occur more frequently in sero-negative women who respond well to therapy with gold salts. Frequent blood monitoring in search for any pronounced or sustained drop in red, white or platelet count, even within normal range could serve as a warning sign for myelotoxicity. Despite intensive supportive measure and specific therapeutic attempts, all three patients eventually died of septic shock.
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References
Forestier, J., L'Aurotherapie dans les rhumatismes chroniques Bull Mem Soc Med Hop de Paris 1929, 53, 323–327.
Fraser, T.N., Gold treatment in rheumatoid arthritis. Ann Rheum Dis 1945, 4, 71–75.
The Research Subcommittee of the Empire Rheumatism Council. Gold therapy in rheumatoid arthritis. Report of a multicentre controlled trial. Ann Rheum Dis 1960, 19, 95–119.
The Research Subcommittee of the Empire Rheumatism Council. Gold therapy in rheumatoid arthritis. Report of a multicentre controlled trial. Ann Rheum Dis 1961, 20, 315–346.
The Cooperating Clinics Committee of the American Rheumatism Association. A controlled trial of gold salt therapy in rheumatoid arthritis. Ann Rheum Dis 1973, 16, 353–358.
Committee on safety of medicines. Br Med J 1971, 1, 471.
Davis, P., Ezeoke, A., Munro, J., Hobbs, J.R., Hughes, G.R.V.. Immunological studies on the mechanism of gold hypersensitivity reactions. Br Med J 1973, 3, 676–678.
Girwood, R.H., Death after taking medicaments, Br Med J, 1974, 1, 501–504.
McCarty, D.J., Brill, M., Harrop, D. Aplastic anemia secondary to gold salt therapy. JAMA 1962, 179, 8, 655–657.
Kay, A.G.L. Myelotoxicity of gold. Br Med J, 1976, 1, 1266/68.
Burnstein, S.L., Staley, H.L., Calabro, J.J. Recovery from aplastic anemia secondary to gold salt therapy. Arthritis Rheum 1977, 20, 7, 1432–1435.
Proude, R.B. A fatality due to the use of gold. Br Med J 1954, 2, 917.
Jessop, J.D. Gold in rheumatoid arthritis. Br Med J 1971, 1, 49–50.
Baldwin, J.L., Storb, R., Thomas, E.D., Marnik, M. Bone marrow transplantation in patients with goldinduced marrow aplasia. Arthritis Rheum 1977, 20, 1043–1048.
Gibson, J., Mc Girr, E.E., York, J., Kronenberg, H. Aplastic anemia in association with gold therapy for rheumatoid arthritis. Aust N Z J Med 1983, 13, 130–134.
Bosset, J.P., Studer, J.M., Girardin, P., Rozenbaum, A., Lenijs, R., Guidet, M., Leconte des Floris, R. Aplasie medullaire aux sels d'or, à propos de deux observations. Sciences Médicales 1980, X, 47, 21–25.
Reychler, R., De Geeter, T., Verbruggen, L.A. Gold-induced aplastic pancytopenia, 14 months survival through multiple transfusions. Clin Rheumatol 1986, 5, 2, 275–277.
Bennett, R.M., Haematological changes in rheumatoid disease. Clin Rheum Dis 1977, 3, 433–458.
Howell, A., Gumple, J.M., Wattes, R.E.W. Depression of bone marrow colony formation in gold-induced neutropenia. Br Med J 1975, 1, 432–434.
Denman, E.J., Denman, A.M. The lymphocyte transformation test and gold hypersensitivity. Ann Rheum Dis 1968, 27, 582.
Measel, J.W. Gold and the immune system. Arthritis Rheum 1978, 21, 7, 785–791.
Gumpel, J.M. Deaths associated with gold treatment: a reassessment Br Med J 1978, 28, 215–216.
Jessop, J.D., Johns, R.G.S. Serum gold determination in patients with rheumatoid arthritis receiving sodium thiomalate. Ann Rheum Dis 1973, 32, 228.
Lorber, A., Atkins, C.O., Chang, C.C., Lee, Y.B., Starrs, J., Bovy, R.A. Monitoring serum gold values to improve chrysotherapy in rheumatoid arthritis. Ann Rheum Dis 1973, 32, 133.
Rubinstein, H.R., Dietz, A.A. Serum gold levels in rheumatoid arthritis. Ann Rheum Dis 1973, 32, 128.
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Williame, L.M.E., Joos, R., Proot, F. et al. Gold- induced aplastic anemia. Clin Rheumatol 6, 600–605 (1987). https://doi.org/10.1007/BF02330601
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DOI: https://doi.org/10.1007/BF02330601