Fatal hepatic necrosis associated with parenteral gold therapy

Two young black male patients with seronegative rheumatoid arthritis and treated with nonsteroidal antiinflammatory agents developed fulminant hepatic necrosis following the institution of parenteral gold therapy. These cases, reported from different institutions, may represent a severe form of idiosyncratic gold hepatonecrosis. Awareness of the possible association between gold therapy and severe hepatic injury may become increasingly important as oral gold preparations become widely available.