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[Hepatitis secondary to a gold salt overdose]
Gastroenterologie Clinique Et Biologique
|August 1, 1984
Summary
A woman experienced drug-induced liver injury (DILI) from a sodium aurothiopropanol sulfonate overdose. Despite treatment with chelating agents, her hepatitis persisted, highlighting potential risks of gold salt therapy.
Area of Science:
- Hepatology
- Toxicology
- Pharmacology
Background:
- Gold salts, like sodium aurothiopropanol sulfonate, are used in treating inflammatory conditions.
- Drug-induced liver injury (DILI) is a significant concern with various therapeutic agents.
Observation:
- A 51-year-old woman presented with cholestatic and cytolytic hepatitis following an overdose of sodium aurothiopropanol sulfonate (1.1 g).
- Liver biopsy revealed cholestasis, centrolobular steatosis, and portal fibrosis, with electron microscopy showing lipo-pigments and myelinic bodies.
- Elevated gold levels were detected in plasma (22.76 µg/ml) and liver (2.16 µg/g).
Findings:
- Chelating agents enhanced urinary gold excretion but did not alter the hepatitis course.
- Dimercaptopropanol appeared to exacerbate other gold salt side effects.
- Penicillamine treatment worsened hepatic cytolysis.
Implications:
- This case underscores the potential hepatotoxicity of gold salts, even at overdose levels.
- The limited efficacy and potential adverse effects of chelating agents in gold-induced hepatitis warrant further investigation.
- Careful patient monitoring is crucial during gold salt therapy to detect and manage potential liver injury.