Skip to main content
SpringerLink
Log in

Adverse Reactions With Oral and Parenteral Gold Preparations

  • Adverse Drug Experience Review
  • Published:
Medical Toxicology and Adverse Drug Experience Aims and scope Submit manuscript

Summary

Auranofin (triethylphosphine gold), an oral gold preparation, has recently been made available, and along with injectable gold preparations, is of therapeutic value for rheumatoid arthritis. Serious gold toxicity is uncommon, and drug-related deaths rare. Many potential adverse reactions are similar, including dermatitis, stomatitis, thrombocytopenia, leucopenia, and proteinuria, generally with increased incidence in the injectable gold-treated patients. Oral gold is associated with benign lower gastrointestinal side effects, including diarrhoea, loose stools and abdominal cramps that are often dose-related and resolve spontaneously. The incidence of severe reactions such as thrombocytopenia, aplastic anaemia and exfoliative dermatitis is lower with oral gold than injectable preparations, and contributes to a superior risk-benefit ratio. The treatment of gold toxicity depends on the type and extent of organ involvement.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Adachi JD, Bensen WG, Singal DP, Powers PJ. Gold-induced thrombocytopenia: platelet associated IgG and HLA typing in three patients. Journal of Rheumatology 11: 355–357, 1984

    PubMed  CAS  Google Scholar 

  • Alarcon GS, Gotuzzo E. Pulmonary reaction to chrysotherapy. Correspondence. New England Journal of Medicine 295: 507, 1976

    Google Scholar 

  • Baldwin JL, Storb R, Thomas ED, Mannik M. Bone marrow transplantation in patients with gold-induced marrow aplasia. Arthritis and Rheumatism 20: 1043–1048, 1977

    PubMed  CAS  Google Scholar 

  • Ball GV. Gold-induced thrombocytopenia response to vincristine? Arthritis and Rheumatism 20: 288–289, 1977

    Google Scholar 

  • Bardin T, Dryll A, Debeyre N, Ryckewaert A, Legrand I, et al. HLA system and side effects of gold salts and d-penicillamine treatment of rheumatoid arthritis. Annals of the Rheumatic Diseases 41: 599–601, 1982

    PubMed  CAS  Google Scholar 

  • Barger BO, Acton RT, Koopman WJ, Alarcon GS. DR antigens and gold toxicity in white rheumatoid arthritis patients. Arthritis and Rheumatism 27: 601–605, 1984

    PubMed  CAS  Google Scholar 

  • Baum J. Arthritis rounds: discussion. Arthritis and Rheumatism 20: 1029, 1977

    Google Scholar 

  • Bensen WG, Moore N, Tugwell P, D’Souza M, Singal DP. HLA antigens and toxic reactions to sodium aurothiomalate in patients with rheumatoid arthritis. Journal of Rheumatology 11: 358–361, 1984

    PubMed  CAS  Google Scholar 

  • Blau SP. Metabolism of gold during lactation. Arthritis and Rheumatism 16: 777, 1973

    PubMed  CAS  Google Scholar 

  • Blocka K. Auranofin versus injectable gold: comparison of pharmacokinetic properties. American Journal of Medicine 75 (Suppl.): 114–122, 1983

    PubMed  CAS  Google Scholar 

  • Blocka KLN, Paulus HE, Furst DE. Clinical pharmacokinetics of oral and injectable gold compounds. Clinical Pharmacokinetics 11: 133–143, 1986

    PubMed  CAS  Google Scholar 

  • Blodgett Jr RC, Heuer MA, Pietrusko RG. Auranofin: a unique oral chrysotherapeutic agent. Seminars in Arthritis and Rheumatism 13: 255–273, 1984

    PubMed  CAS  Google Scholar 

  • Browning JS, Rice RM, Lee WV, Baker LM. Gold therapy in rheumatoid arthritis. New England Journal of Medicine 237: 428–431, 1947

    PubMed  CAS  Google Scholar 

  • Coblyn JS, Weinblatt M, Holdsworth D, Glass D. Gold-induced thrombocytopenia. Annals of Internal Medicine 95: 178–181, 1981

    PubMed  CAS  Google Scholar 

  • Cohen DL, Orzel J, Taylor A. Infants of mothers receiving gold therapy. Arthritis and Rheumatism 24: 104–105, 1981

    PubMed  CAS  Google Scholar 

  • Combs RJ, Dentino MM, Lehrman L, Szwed JJ. Gold toxicity and peritoneal dialysis. Arthritis and Rheumatism 19: 936–938, 1976

    PubMed  CAS  Google Scholar 

  • Davidson P, Engelman EP. Effect of orally administered d-penicillamine on gold deposited in the rat kidney. Arthritis and Rheumatism 7: 406–413, 1964

    PubMed  CAS  Google Scholar 

  • Davis P. Barraclough D. Interaction of d-penicillinamine with gold salts. Arthritis and Rheumatism 20: 1413, 1977

    CAS  Google Scholar 

  • Davis P, Menard H, Thompson J, Harth M, Beaudet F. One-year comparative study of gold sodium thiomalate and auranofin treatment of rheumatoid arthritis. Journal of Rheumatology 12: 60–67, 1985

    PubMed  Google Scholar 

  • Deren B, Masi R, Weksler M, Nachman RL. Gold-associated thrombocytopenia. Archives of Internal Medicine 134: 1012–1015, 1974

    PubMed  CAS  Google Scholar 

  • Edelman J, Donnelly R, Graham DN, Percy JS. Liver dysfunction associated with gold therapy for rheumatoid arthritis. Journal of Rheumatology 10: 510–511, 1983

    PubMed  CAS  Google Scholar 

  • Eiseman JL, Alvares AP. Heme metabolism in the fetoplacental unit and neonatal livers during lactation: effect of gold sodium thiomalate. Journal of Pharmacology and Experimental Therapeutics 214: 250–256, 1980

    PubMed  CAS  Google Scholar 

  • Evans RB, Ettensohn DB, Fawaz-Estrup F, Lally EV, Kaplan SR. Gold lung: recent developments in pathogenesis and therapy. Seminars in Arthritis and Rheumatism 16: 196–205, 1987

    PubMed  CAS  Google Scholar 

  • Eyring EJ, Engelman EP. Interaction of gold and penicillamine. Arthritis and Rheumatism 6: 216–223, 1963

    CAS  Google Scholar 

  • Fam AG, Paton TW, Shamess CJ, Lewis AJ. Fulminant colitis complicating gold therapy. Journal of Rheumatology 7: 479–485, 1980

    PubMed  CAS  Google Scholar 

  • Fam AG, Gordon DA, Sarkozi J, Blair GRD, Cooper PW, et al. Neurologic complications associated with gold therapy for rheumatoid arthritis. Journal of Rheumatology 11: 700–706, 1984

    PubMed  CAS  Google Scholar 

  • Favreau M, Tannenbaum H, Lough J. Hepatic toxicity associated with gold therapy. Annals of Internal Medicine 87: 717–719, 1977

    PubMed  CAS  Google Scholar 

  • Ford PM. HLA antigens and drug toxicity in rheumatoid arthritis. Journal of Rheumatology 11: 259–261, 1984

    PubMed  CAS  Google Scholar 

  • Forestier J. Rheumatoid arthritis and its treatment by gold salts. Journal of Laboratory and Clinical Medicine 20: 827–840, 1935

    Google Scholar 

  • Garland JS, Sheth KJ, Wortmann DW. Poor clearance of gold using peritoneal dialysis for the treatment of gold toxicity. Arthritis and Rheumatism 29: 450–451, 1986

    PubMed  CAS  Google Scholar 

  • Geddes DM, Brostoff J. Pulmonary fibrosis associated with hypersensitivity to gold salts. British Medical Journal 1: 1444, 1976

    PubMed  CAS  Google Scholar 

  • Gibson J, McGirr EE, York J, Kronenberg H. Aplastic anemia in association with gold therapy for rheumatoid arthritis. Australian and New Zealand Journal of Medicine 13: 130–135, 1983

    PubMed  CAS  Google Scholar 

  • Godfrey NF, Peter A, Simon TN, Lorber A. IV n-acetylcysteine treatment of hematologic reactions to chrysotherapy. Journal of Rheumatology 9: 519–526, 1982

    PubMed  CAS  Google Scholar 

  • Gottlieb NL. Chrysotherapy. Bulletin on the Rheumatic Diseases 27: 912–917, 1976-1977

    PubMed  Google Scholar 

  • Gottlieb NL. Comparative pharmacokinetics of parenteral and oral gold compounds. Journal of Rheumatology 9 (Suppl. 8): 99–109, 1982

    Google Scholar 

  • Gottlieb NL. Gold compounds. In Kelley et al. (Eds) Textbook of rheumatology, pp.789–809, WB Saunders Co., Philadelphia, 1985a

    Google Scholar 

  • Gottlieb NL. Auranofin. In Roth et al. (Eds) Rheumatic therapeutics pp. 442–456, McGraw-Hill Book Co, New York, 1985b

    Google Scholar 

  • Gottlieb NL, Brown HE. Acute myocardial infarction following gold sodium thiomalate induced vasomotor (nitritoid) reaction. Arthritis and Rheumatism 20: 1026–1028, 1977

    PubMed  CAS  Google Scholar 

  • Gottlieb NL, Gray RG. Diagnosis and management of adverse reactions from gold compounds. Journal of Analytical Toxicology 2: 173, 1978

    Google Scholar 

  • Gottlieb NL, Major JC. Ocular chrysiasis correlated with gold concentrations in the crystalline lens during chrysotherapy. Arthritis and Rheumatism 21: 704–708, 1978

    PubMed  CAS  Google Scholar 

  • Gould PW, McCormack PL, Palmer DG. Pulmonary damage associated with sodium aurothiomalate therapy. Journal of Rheumatology 4: 252–260, 1977

    PubMed  CAS  Google Scholar 

  • Gran JT, Husby G, Thorsby E. HLA DR antigens and gold toxicity. Annals of the Rheumatic Diseases 42: 63–66, 1983

    PubMed  CAS  Google Scholar 

  • Gray RG, Gottlieb NL. Adverse reactions from antirheumatic drugs. In Utsinger et al. (Eds) Rheumatoid arthritis, pp. 655–681, JB Lippincott, Philadelphia 1985

    Google Scholar 

  • Harth M, Hickey JP, Coulter WK, Thompson JN, Disney TF. Gold-induced thrombocytopenia. Journal of Rheumatology 5: 165–172, 1978

    PubMed  CAS  Google Scholar 

  • Hashimoto A, Maeda Y, Ito H, Okazaki M, Hara T. Corneal chrysiasis. Arthritis and Rheumatism 15: 309–312, 1972

    PubMed  CAS  Google Scholar 

  • Heuer MA, Morris RW. Smith Kline & French worldwide clinical experience with auranofin: a review. In Capell et al. (Eds) International Symposium on auranofin, pp. 474–503, Excerpta Medica, Amsterdam, 1983

    Google Scholar 

  • Heuer MA, Pietrusko RG, Morris RW, Scheffler BJ. An analysis of worldwide safety experience with auranofin. Journal of Rheumatology 12: 695–699, 1985

    PubMed  CAS  Google Scholar 

  • Holness L, Tenenbaum J, Cooter NBE, Grossman RF. Fatal bronchiolitis obliterans associated with chrysotherapy. Annals of the Rheumatic Diseases 42: 593–596, 1983

    PubMed  CAS  Google Scholar 

  • James DW, Whimster WF, Hamilton EBD. Gold lung. British Medical Journal 1: 1523–1524, 1978

    PubMed  CAS  Google Scholar 

  • Jarner D, Nielsen AM. Auranofin induced enterocolitis in rheumatoid arthritis: a case report. Scandinavian Journal of Rheumatology 12: 254–256, 1983

    PubMed  CAS  Google Scholar 

  • Jeffrey DA, Biggs DF, Percy JS, Russell AS. Quantitation of gold in skin in chrysiasis. Journal of Rheumatology 2: 28–35, 1975

    Google Scholar 

  • Kaplinsky N, Pras M, Frankl O. Severe enterocolitis complicating chrysotherapy. Annals of the Rheumatic Diseases 32: 574–577, 1973

    PubMed  CAS  Google Scholar 

  • Katz WA, Blodgett Jr RC, Pietrusko RG. Proteinuria in gold-treated rheumatoid arthritis. Annals of Internal Medicine 101: 176–179, 1984

    PubMed  CAS  Google Scholar 

  • Kay A. Depression of bone marrow and thrombocytopenia associated with chrysotherapy. Annals of the Rheumatic Diseases 32: 277–278, 1973

    PubMed  CAS  Google Scholar 

  • Kean WF, Anastassiades TP. Long term chrysotherapy. Arthritis and Rheumatism 22: 495–501, 1979

    PubMed  CAS  Google Scholar 

  • Kean WF, Bellamy N, Brooks PM. Gold therapy in the elderly rheumatoid arthritis patient. Arthritis and Rheumatism 26: 705–711, 1983

    PubMed  CAS  Google Scholar 

  • Kidston ME, Beck F, Lloyd JB. The teratogenic effects of myochrysine injection in rats. Journal of Anatomy 108: 590–591, 1971

    Google Scholar 

  • Klinefelter EL. Reinstitution of gold therapy in rheumatoid arthritis after mucocutaneous reactions. Journal of Rheumatology 2: 21–27, 1975

    PubMed  CAS  Google Scholar 

  • Koch R. Report of address at tenth international medical congress, Berlin, August 4, 1890. Deutsche Medizinische Wochenschrift 16: 756–757, 1890

    Google Scholar 

  • Levin HA, McMillan R, Tavassoli M, Longmire RL, Yelenoseky R, et al. Thrombocytopenia associated with gold therapy. American Journal of Medicine 59: 274–280, 1975

    PubMed  CAS  Google Scholar 

  • Levinson ML, Lynch JP, Bower JS. Reversal of progressive, life-threatening gold hypersensitivity pneumonitis by corticosteroids. American Journal of Medicine 71: 908–912, 1981

    PubMed  CAS  Google Scholar 

  • Lockie LM, Norcross BM, Cross CW. Treatment of two reactions due to gold. Journal of the American Medical Association 133: 754–755, 1947

    PubMed  CAS  Google Scholar 

  • Madhok R, Pullar T, Capell H, Dawood F, Sturrock R, et al. Chrysotherapy and thrombocytopenia. Annals of the Rheumatic Diseases 44: 589–591, 1985

    PubMed  CAS  Google Scholar 

  • McCarty DJ, Brill JM, Harrop D. Aplastic anemia secondary to gold-salt therapy. Journal of the American Medical Association 179: 655–657, 1962

    Google Scholar 

  • McCormick J, Cole S, Laherre M, et al. Pneumonitis caused by gold salt therapy, evidence for the role of cell-mediated immunity in its pathogenesis. American Review of Respiratory Disease 122: 145–152, 1980

    PubMed  CAS  Google Scholar 

  • Menard HA, Beaudet F, Davis P, et al. Gold therapy in rheumatoid arthritis: interim report of the Canadian multicenter prospective trial comparing sodium aurothiomalate and auranofin. Journal of Rheumatology 9: 179–183, 1982

    Google Scholar 

  • Miyamoto T, Miyaji S, Horiochi Y, Hara M, Ishihara K. Gold therapy in bronchial asthma: special emphasis upon blood levels of gold and its teratogenicity. Journal of Japanese Society of Internal Medicine 63: 1190–1197, 1970

    Google Scholar 

  • Miyachi S, Iwai K, Makino S, et al. Studies on pneumonitis occurring during chrysotherapy. Japanese Journal of Thoracic Diseases 13: 653–662, 1975

    PubMed  CAS  Google Scholar 

  • Nelson DC, Birchmore DA. Renal vein thrombosis associated with nephrotic syndrome and gold therapy in rheumatoid arthritis. Southern Medical Journal 72: 1616–1618, 1979

    PubMed  CAS  Google Scholar 

  • Penneys NS, Ackerman AB, Gottlieb NL. Gold dermatitis. Archives of Dermatology 109: 372–376, 1974

    PubMed  CAS  Google Scholar 

  • Perrier P, Raffoux C, Thomas P, Tamisier JN, Busson M, et al. HLA antigens and toxic reactions to sodium aurothiopropanol sulphonate and d-penicillamine in patients with rheumatoid arthritis. Annals of the Rheumatic Diseases 44: 621–624, 1985

    PubMed  CAS  Google Scholar 

  • Pessayre D, Feldman G, Degott C, et al. Gold salt-induced cholestasis. Digestion 19: 56–64, 1979

    PubMed  CAS  Google Scholar 

  • Podell TE, Klinenberg JR, Kramer LS, Brown HV. Pulmonary toxicity with gold therapy. Arthritis and Rheumatism 23: 347–350, 1980

    PubMed  CAS  Google Scholar 

  • Prouse PJ, Kanski JJ, Gumpel JM. Corneal chrysiasis and clinical improvement with chrysotherapy in rheumatoid arthritis. Annals of the Rheumatic Diseases 40: 564–566, 1981

    PubMed  CAS  Google Scholar 

  • Prupas HM. Stroke-like syndrome after gold sodium thiomalate induced vasomotor reaction. Journal of Rheumatology 11: 235–236, 1984

    PubMed  CAS  Google Scholar 

  • Reidenberg MM, Lowenthal DT. Adverse nondrug reactions. New England Journal of Medicine 279: 678–679, 1968

    PubMed  CAS  Google Scholar 

  • Roberts W, Wolter JR. Ocular chrysiasis. Archives of Ophthalmology 56: 48–52, 1974

    Google Scholar 

  • Rocker I, Henderson WJ. Transfer of gold from mother to fetus. Lancet 2: 1246, 1976

    PubMed  CAS  Google Scholar 

  • Roe M, Sears AD, Arndt JH. Gold reaction panenteritis: a case report with radiographic findings. Radiology 104: 59, 1972

    PubMed  CAS  Google Scholar 

  • Rogers JG, Anderson RM, Chow CW, Gillam GI, Markman I. Possible teratogenic effects of gold. Australian Pediatric Journal 16: 194–195, 1980

    CAS  Google Scholar 

  • Roquer J, Herraiz J, Maymo J, Oliva A, Carbonell J. Miller-Fisher syndrome (Guillain-Barre syndrome with ophthalmoplegia) during treatment with gold salts in a patient with rheumatoid arthritis. Arthritis and Rheumatism 28: 838–839, 1983

    Google Scholar 

  • Ross GL. Idiosyncratic reactions to gold salt preparations. Arthritis and Rheumatism 21: 281, 1978

    PubMed  CAS  Google Scholar 

  • Rubin M, Sliwinski A, Photias M, et al. Influence of chelation on gold metabolism in rats. Proceeding of the Society for Experimental Biology and Medicine 124: 290–296, 1967

    CAS  Google Scholar 

  • Savilhati M. Pulmonary complications following use of gold salts. Annals of Internal Medicine 37: 263–266, 1948

    Google Scholar 

  • Scharf J, Nahir M, Nirenberg L. Ventricular tachycardia caused by gold overdose. Arthritis and Rheumatism 19: 1373–1374, 1976

    PubMed  CAS  Google Scholar 

  • Scharf J, Nahir M, Kleinhaus U, et al. Diffuse pulmonary injury associated with gold therapy. Journal of the American Medical Association 237: 2412, 1977

    PubMed  CAS  Google Scholar 

  • Schenker S, Olson KN, Dunn D, Breen MB, Combes B. Intrahepatic cholestasis due to therapy of rheumatoid arthritis. Gastroenterology 64: 622–629, 1973

    PubMed  CAS  Google Scholar 

  • Scherak O, Smollen JS, Mayr WR, Mayrhofer F, Kolarz G, et al. HLA antigens and toxicity to gold and penicillamine in rheumatoid arthritis. Journal of Rheumatology 11: 610–614, 1984

    PubMed  CAS  Google Scholar 

  • Schlumpf U, Meyer M, Ulrich J, et al. Neurologic complications induced by gold treatment. Arthritis and Rheumatism 26: 825–831, 1983

    PubMed  CAS  Google Scholar 

  • Scott DL, Bradby GVH, Aitman TJ, Zaphiropoulos GC, Hawkins CF. Relationship of gold and penicillamine therapy to diffuse interstitial lung disease. Annals of the Rheumatic Diseases 40: 136–141, 1981

    PubMed  CAS  Google Scholar 

  • Segawa K. Electron microscopy of the trabecular meshwork in open-angle glaucoma associated with gold therapy. Glaucoma: 257–258, 1981

  • Sepuya SM, Grzybowski S, Burton JD, et al. Diffuse lung changes associated with gold therapy. Canadian Medical Association Journal 118: 816–818, 1978

    PubMed  CAS  Google Scholar 

  • Shapiro R, Weisner K, McLaughlin GE, Utsinger PD. Evaluation as a prelude to management; management of patients. In Utsinger et al. (Eds) Rheumatoid arthritis, pp. 504–544, JB Lippincoth Philadelphia, 1985

  • Sharma RP, Smillie J, Palmer DG. Gold concentrations and toxicity during oral gold treatment with auranofin. Pharmacology 30: 115–120, 1985

    PubMed  CAS  Google Scholar 

  • Silverberg DS, Kidd EG, Shnitka TK, Ulan RA. Gold nephropathy. Arthritis and Rheumatism 13: 812–825, 1970

    PubMed  CAS  Google Scholar 

  • Skrifvars BV, Tornroth TS, Tallqvist GN. Gold-induced immune complex nephritis in seronegative rheumatoid arthritis. Annals of the Rheumatic Diseases 36: 549–566, 1977

    PubMed  CAS  Google Scholar 

  • Smith RT, Peak WP, Kron KM. Increasing the effectiveness of gold therapy in rheumatoid arthritis. Journal of the American Medical Association 167: 1197–1204, 1958

    PubMed  CAS  Google Scholar 

  • Smith W, Ball GV. Lung injury due to gold treatment. Arthritis and Rheumatism 23: 351–354, 1980

    PubMed  CAS  Google Scholar 

  • Speerstra F, Reekers P, van de Putte LBA, Vandenbroucke JP, Rasker JJ, et al. HLA-DR antigens and proteinuria induced by aurothioglucose and d-penicillamine in patients with rheumatoid arthritis. Journal of Rheumatology 10: 948–953, 1983

    PubMed  CAS  Google Scholar 

  • Stein HB, Urowitz MB. Gold-induced enterocolitis. Journal of Rheumatology 3: 21–26, 1976

    PubMed  CAS  Google Scholar 

  • Szabo KT, Guerriero FJ, Kang YJ. The effects of gold-containing compounds on pregnant rats and their fetuses. Veterinary Pathology (S) 15: 89–96, 1978a

    CAS  Google Scholar 

  • Szabo KT, DiFebbo ME, Phelan DG. The effects of gold-containing compounds on pregnant rabbits and their fetuses. Veterinary Pathology (S) 15: 97–102, 1978b

    CAS  Google Scholar 

  • Szpak MW, Johnson RC, Brady CE, et al. Gold (Au) induced enterocolitis. Gastroenterology 76: 1257, 1979

    Google Scholar 

  • Tarp U, Graudal H. A followup study of children exposed to gold compounds in utero. Arthritis and Rheumatism 28: 235–236, 1985

    PubMed  CAS  Google Scholar 

  • Tornroth TS, Skrifvars B. Gold nephropathy: prototype of membranous glomerulonephritis. American Journal of Pathology 75: 573–590, 1974

    Google Scholar 

  • Vaamonde CA, Hunt FR. The nephrotic syndrome as a complication of gold therapy. Arthritis and Rheumatism 13: 826–834, 1970

    PubMed  CAS  Google Scholar 

  • Wenger ME, Bernard GC, Heller MD, et al. Therapy for rheumatoid arthritis: transferring treatment from injectable gold to aurarofin. In Capell et al. (Eds) Internation Symposium on Auranofin, pp. 201–210, Excerpta Medica, Amsterdam 1983

    Google Scholar 

  • Winterbauer RH, Wilske KR, Wheelis RF. Diffuse pulmonary injury associated with gold treatment. New England Journal of Medicine 294: 919–921, 1976

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Arthritis, Department of Medicine, University of Miami School of Medicine, Box 016960, Miami, FL, 33101, USA

    Elaine C. S. Tozman (Assistant Professor) & Norman L. Gottlieb

Authors
  1. Elaine C. S. Tozman
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Norman L. Gottlieb
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tozman, E.C.S., Gottlieb, N.L. Adverse Reactions With Oral and Parenteral Gold Preparations. Med Toxicol Adverse Drug Exp 2, 177–189 (1987). https://doi.org/10.1007/BF03259863

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03259863

Keywords

Search

Navigation