[Fatal pulmonary fibrosis caused by gold therapy?]

The case of a 33-year-old female patient with rheumatoid arthritis who developed a severe pulmonary fibrosis during chrysotherapy of 3.5 months' duration is reported. The course of the fibrosis was progressive and led to respiratory insufficiency and death. The microscopic picture revealed a honeycomb lung with perialveolar proliferation of connective tissue and mononuclear cell infiltration. The clinical and temporal circumstances gave evidence that this pulmonary fibrosis is possibly to be interpreted as a gold-induced lung disease, though a causal connection could not be established with absolute security. However, gold-induced pulmonary fibrosis is usually completely reversible and has no fatal outcome: this would be the first report of a lethal outcome of a gold-induced pulmonary fibrosis. The clinical data of 39 further cases of gold-induced pulmonary fibrosis published elsewhere are presented.