[Toxic cholestatic hepatitis secondary to chrysotherapy]

Area of Science:

• Hepatology
• Rheumatology
• Toxicology

Background:

• Rheumatoid arthritis (RA) is a chronic autoimmune disease.
• Gold salts have been used historically for RA treatment.
• Drug-induced liver injury (DILI) is a significant concern in pharmacotherapy.

Observation:

• A patient undergoing RA treatment with gold salts developed cholestatic toxic hepatitis.
• Hepatotoxicity was suspected due to the absence of other hepatotoxic agents and exclusion of alternative liver diseases.
• Histological findings were consistent with previously reported cases of gold salt-induced liver injury.

Findings:

• Gold salts (colloidal sulphide) can induce cholestatic toxic hepatitis.
• Histological examination confirmed the diagnosis, ruling out other causes.
• The clinical presentation and pathology align with rare international literature reports.

Implications:

• Clinicians should consider gold salt-induced hepatotoxicity in RA patients presenting with cholestatic hepatitis.
• Monitoring liver function is crucial for patients on gold salt therapy.
• This case adds to the understanding of rare adverse effects of gold salts in rheumatology.