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Diffuse pulmonary injury associated with gold treatment.
The New England Journal of Medicine
|April 22, 1976
Summary
Gold sodium thiomalate treatment can cause reversible lung injury in patients with arthritis. Discontinuation of gold therapy and corticosteroid treatment led to symptom resolution in two cases.
Area of Science:
- Rheumatology
- Pulmonology
- Toxicology
Background:
- Gold sodium thiomalate is a treatment for rheumatoid arthritis.
- Adverse pulmonary reactions to gold therapy are rare but serious.
Observation:
- Two patients developed diffuse pulmonary injury during gold sodium thiomalate treatment.
- Symptoms included cough and dyspnea, with bilateral pulmonary infiltrates on x-ray.
- Lung biopsies showed inflammation and fibrosis.
Findings:
- Pulmonary symptoms resolved after discontinuing gold therapy.
- One patient experienced symptom recurrence upon re-challenge with gold.
- Corticosteroid treatment led to prompt remission in the other patient.
Implications:
- Gold sodium thiomalate can induce reversible lung injury.
- Pulmonary function monitoring may be warranted during gold therapy.
- Prompt recognition and management are crucial for favorable outcomes.