Another hazard of gold therapy?
Annals of the Rheumatic Diseases
|February 1, 1982
Summary
A patient developed a skin reaction to gold treatment due to a nickel allergy. Nickel contamination in the medication caused the bullous eruption, not gold itself.
Area of Science:
- Rheumatology
- Dermatology
- Allergology
Background:
- Rheumatoid arthritis is a chronic autoimmune disease.
- Gold compounds like sodium aurothiomalate were historically used for rheumatoid arthritis treatment.
- Allergic reactions to medications require careful investigation to identify the causative agent.
Observation:
- A patient with seropositive rheumatoid arthritis presented with a localized bullous eruption.
- The eruption appeared in jewelry areas 12 hours after a test dose of sodium aurothiomalate (Myocrisin).
- Initial suspicion was a gold allergy, but further investigation revealed a nickel allergy.
Findings:
- The patient exhibited a clear allergy to nickel, not gold.
- Trace amounts of nickel were detected in the Myocrisin solution.
- Nickel contamination likely occurred due to contact with a metal needle during preparation.
Implications:
- This case highlights the importance of considering metal allergies beyond the primary drug component.
- Contamination of injectable medications with other metals can trigger unexpected allergic reactions.
- Further quality control measures for injectable gold compounds are warranted to prevent nickel contamination.
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