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Gold-induced thrombocytopenia.

M Harth, J P Hickey, W K Coulter

    The Journal of Rheumatology
    |January 1, 1978
    PubMed
    Summary
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    Gold sodium thiomalate treatment for rheumatoid arthritis can cause thrombocytopenia (low platelet count) without bone marrow damage. Most patients recovered with steroid therapy, indicating a potential immune-mediated drug reaction.

    Area of Science:

    • Rheumatology
    • Hematology
    • Pharmacology

    Background:

    • Rheumatoid arthritis (RA) is a chronic autoimmune disease.
    • Gold sodium thiomalate is a disease-modifying antirheumatic drug (DMARD) used in RA treatment.
    • Thrombocytopenia is a potential adverse effect of gold therapy.

    Purpose of the Study:

    • To investigate the occurrence and characteristics of thrombocytopenia in RA patients treated with gold sodium thiomalate.
    • To explore the potential mechanism of gold-induced thrombocytopenia.

    Main Methods:

    • Observational study of ten RA patients who developed thrombocytopenia.
    • Clinical assessment of bleeding symptoms (petechiae, purpura, echymoses).
    • Measurement of serum gold levels.

    Related Experiment Videos

  • In vitro lymphocyte culture with gold and tritiated thymidine incorporation.

    • Main Results:

    • Ten RA patients developed thrombocytopenia without bone marrow aplasia.
    • Eight patients exhibited bleeding symptoms.
    • Serum gold levels were not significantly elevated.
    • In vitro lymphocyte culture showed increased thymidine incorporation in response to gold in three patients.

    Conclusions:

    • Gold sodium thiomalate can induce thrombocytopenia in RA patients, likely via an immune-mediated mechanism.
    • Steroid therapy is effective in managing gold-induced thrombocytopenia.
    • Monitoring for thrombocytopenia is crucial in patients receiving gold therapy.