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PubMedDate not supplied

[Hepatotoxicity and pancreatitis associated with gold salts: case report].

The case of a patient, 37 years old, born and resident of Lima, suffering rheumatoid arthritis who underwent treatment with prednisone, methotrexate, and chloroquine is reported. This therapy was substituted for gold salts one month before her admission. After the third dose she presented symptoms of abdominal pain and diarrhea, itching, and jaundice, associated with asthenia and a feverish sensation. Liver biochemistry demonstrated elevated transaminase, bilirubin, alkaline phosphatase, eosinophilia, inversion of the rate albumin/globulin, higher titer of immunoglobulin G, as well as an elevation of amylase and lipase. The anatomopathological study showed cholestasis, hepatocyte ballooning, spotty necrosis, predominantly in zone 3 of the acinus. These findings where found consistent with a toxic reaction.

Adult↗
PubMed2005

Longterm outcome of treatment of Felty's syndrome with intramuscular gold: case reports and recommendations for management.

OBJECTIVE: To evaluate the incidence, complications, and course of Felty's syndrome (FS) in patients treated with intramuscular (IM) gold. METHODS: Retrospective chart review of all FS cases (1979 to 2003) was conducted in the Mary Pack Arthritis Centre (MPAC) gold clinic. FS was diagnosed if patients had rheumatoid arthritis (RA; American College of Rheumatology criteria) and persistent leukopenia [white blood cell (WBC) count < 4] in the absence of other known causes of leukopenia. Splenomegaly was not part of the inclusion criteria. RESULTS: Thirteen patients with FS were identified in the gold clinic population. The mean age at diagnosis of FS was 58.7 years and the mean duration of RA at time of diagnosis was 6.9 years. The weekly dose of gold ranged from 10 mg to 50 mg depending on tolerability. Gold therapy resulted in normalization of the WBC count in 9 of 13 patients. The mean time to normalization of the WBC was 40 weeks. Only one patient with FS had experienced recurrent infectious complications from FS, and this did not recur after gold treatment was initiated. No patient had vasculitis. CONCLUSION: In our gold clinic population FS is a mild disease and is rarely associated with infectious complications. Gold is an effective treatment of FS.

Adult↗
PubMed1991

[The effect of aurotherapy on the content of corticotropin, cortisol, aldosterone and insulin in the blood serum of rheumatoid arthritis patients].

The author studied the content of corticotropin, cortisol, aldosterone, insulin in the blood serum of 69 patients with rheumatoid arthritis depending on the grade of activity of the inflammatory process before treatment in the course of aurotherapy within 12 months. It was established that in patients with rheumatoid arthritis changes develop in the system of pituitary-peripheral endocrine glands, namely, an increase of the concentration of corticotropin, aldosterone and a reduction of the level of cortisol and insulin indicating the participation of hormones in the pathogenesis of rheumatoid arthritis. Non-steroid antiinflammatory preparations and quinolinic derivatives did not effect the hormonal spectrum of rheumatoid arthritis. Prolonged aurotherapy resulted in a positive dynamics in the contents of hormones.

Adrenocorticotropic Hormone↗
PubMed1991

[Gold salts].

Explore the source record for details and available documents.

Antirheumatic Agents↗
PubMed1991

[Clinical notes about methylprednisolone pulse-therapy in patients with rheumatoid arthritis].

From the analysis of literature and first-hand data on methylprednisolone pulse-therapy for rheumatoid arthritis (RA) the conclusion is made that such therapy produces a rapid and pronounced though short-term effect on the disease activity. It fails to stop RA progression. A case of two-wave effect is attributed to restoration of target cell sensitivity to chrysotherapy.

Antirheumatic Agents↗
PubMed1991

[Clinicopathological study of nephropathy in patients with rheumatoid arthritis].

We carried out a retrospective study to investigate the clinical and pathological findings in 31 patients with rheumatoid arthritis (RA). In clinical findings, 17 patients showed nephrotic syndrome, five had isolated proteinuria, two had proteinuria and hematuria and seven had renal failure. In pathological findings, there were 16 patients with membranous nephropathy (MN), two with proliferative glomerulonephritis (DPGN), two with minor glomerular abnormality (MGA), six with amyloidosis, 2 with tubulointerstitial nephritis, and three patients had accompanying lupus nephritis. Eleven of 16 with MGN had been treated with gold, bucillamine or D-penicillamine, so they were diagnosed as drug induced MGN. In the other five patients, we could not decide which drugs induced the nephropathy. The 2 cases of MGA were associated with nephrotic syndrome and acute renal failure, which were caused by non-steroidal antiinflammatory drugs. There were two cases of non-Ig A DPGN, which was regarded as the native nephropathy in RA. The three cases with lupus nephritis were diagnosed as systemic lupus erythematosus by the criteria of the American Rheumatism Association (ARA). In conclusion, the nephropathy in patients with RA was varied and renal biopsy was a useful examination.

Adult↗
PubMed1991

[Fatal hepatic necrosis due to a treatment course of rheumatoid arthritis with gold salts].

Gold salts are still a first choice for treatment of rheumatoid arthritis. Although adverse reactions are relatively frequent, hepatic abnormalities are rare. They consist largely of reversible cholestasis, and, exceptionally, the evolution can prove rapidly fatal due to extensive hepatic necrosis. We present an additional case of this kind which occurred after a total dose of 450 mg intramuscular Aurothiopropanol over 6 weeks. The pathogenetic mechanism is complex, toxic and/or immuno-allergic. Nevertheless, regular hepatic enzyme testing is not recommended.

Antirheumatic Agents↗
PubMed1991

[A comparative evaluation of parenteral and oral preparations of gold and D-penicillamine in the treatment of rheumatoid nephropathy].

Analysis is made of the results of the treatment with parenteral (crysanol and myochrysine) and oral (ridaura) gold drugs as well as with small doses of D-penicillamine (DP) of patients suffering from rheumatoid arthritis with the signs of nephropathy. The latter ones were identified, respectively, in 18 out of 80 patients who began receiving treatment, in 17 out of 72, and in 16 out of 61 patients. The clinical, laboratory, instrumental and morphological manifestations of nephropathy are described and analysis of their dynamics under the treatment impact is provided. It is noted that these types of basic therapy produce a beneficial effect on the manifestations of rheumatoid nephropathy. That referred to a greater measure to the gold drugs than to the small doses of DP. The degree of counteracting the symptoms of renal pathology agreed well with a good clinical effect in respect to the articular syndrome and inflammatory responses of blood. Among patients receiving crysanol, iatrogenic nephropathy was recorded in 8.75% of cases, among those on ridaura, in 2.8%, and those on DP, in 8.2% of cases. The authors provide evidence for the use of gold drugs and DP in patients suffering from rheumatoid nephropathy.

Administration, Oral↗
PubMed1991

[Therapy strategies for Still's syndrome of adults (AOSD)].

The differential diagnosis of seronegative polyarthritides are manyfold and can cause problems even for the routine rheumatologist. Together with the symptom "fever of unknown origin" an intensive diagnostic workup is often unavoidable. Five patients with this symptom combination are discussed who also had different typical manifestations of the adult onset Still's disease (AOSD).

Adolescent↗