Gold-induced thrombocytopenia

Ten patients with rheumatoid arhritis treated with gold sodium thiomalate developed thrombocytopenia without bone marrow asplasia. There was no life-threatening blood loss, but petechiae, purpura, or echymoses were seen in eight patients. The serum gold levels monitored in one patient did not exceed levels seen in patients without thrombocytopenia. In three cases peripheral blood lymphocytes were cultured in the presence of gold and tritiated thymidine incorporation was significantly increased. Eight patients responded to steroid therapy, one patient to BAL and pencillamine, and one patient to vincristine.