[A case of oral gold tablet-induced interstitial pneumonitis]

A 76-year-old woman was admitted with exertional dyspnea and chest roentgenographical abnormal shadows appearing after oral gold therapy (total 720 mg) for rheumatoid arthritis. Based on the patient's clinical course, chest roentgenograms, chest CT and pathological findings of TBLB specimens, gold pneumonitis was diagnosed. Steroid therapy improved symptoms and pulmonary function and cotton-like shadows on chest roentgenograms and chest CT scanning. However, linear and large ringed shadows on chest roentgenograms and chest CT scan remained, even after steroid therapy. This case is the first case of oral gold tablet-induced pneumonitis. Although the mechanism of oral gold tablet-induced pneumonitis is considered to be almost the same that of gold injection therapy-induced pneumonitis, this case suggested that fibrotic changes in oral gold tablet-induced pneumonitis may be delayed over a long period.