Neutropenia occurring during the course of chrysotherapy: a review of 25 cases

The records of 25 patients who developed neutropenia (granulocyte count less than or equal to 2500 mm3) while receiving intramuscular gold sodium aurothiomalate (GSTM) were reviewed. According to commonly used clinical criteria, 3 patients developed Felty's syndrome, 8 gold myelotoxicity, and 14 mild, chronic benign granulocytopenia. Myelotoxicity occurred exclusively during the initial course of therapy (less than or equal to 1 g GSTM). Twelve of the patients with chronic granulocytopenia continue to receive gold without other signs of serious toxicity. We conclude that Felty's syndrome can develop during gold administration, and that many patients may continue safely to receive gold despite neutropenia.