Pulmonary gold toxicity

Area of Science:

• Rheumatology
• Pulmonology
• Pharmacology

Background:

• Rheumatoid arthritis is a chronic autoimmune disease.
• Sodium aurothiomalate is a gold salt therapy used for rheumatoid arthritis.
• Drug-induced lung injury is a potential complication of gold salt therapy.

Observation:

• A 52-year-old female presented with fever, cough, and dyspnea after 8 weeks of sodium aurothiomalate treatment.
• The patient exhibited severe hypoxemia and bilateral pulmonary infiltrates on imaging.
• These symptoms suggest a significant pulmonary reaction to the medication.

Findings:

• The clinical presentation was consistent with drug-induced pneumonitis.
• Hypoxemia and pulmonary infiltrates indicated severe lung involvement.
• The patient's condition necessitated intervention beyond the initial treatment.

Implications:

• This case highlights the importance of monitoring for pulmonary complications during gold salt therapy for rheumatoid arthritis.
• Early recognition and intervention with corticosteroids, such as prednisone, can lead to favorable outcomes.
• Physicians should consider drug-induced lung disease in patients on sodium aurothiomalate presenting with respiratory symptoms.