[Pulmonary side effects of gold treatment]

On the basis of more than 35 cases from literature a survey of clinical and paraclinical findings, diagnostic criteria, differential diagnosis, therapy and prognosis of the pulmonary reaction evoked by gold is given. The first symptoms mostly appear within the initial phase of the treatment, after several weeks to months. Unexpectedly increasing dyspnoea, weakness, cough and feeling of sickness in patients who are treated with gold salts are warning signals which refer to the possibility of a lung injury by gold. The differential-diagnostic demarcation from rheumatoid lung, a rare extraarticular manifestation of the rheumatoid arthritis, may render difficulties. The latter, however, usually refers to a slower progressing, is not or only incompletely able to involution and scarcely reacts to cortisonoids. The gold-conditioned pulmonary changes in most cases completely involve after a well-timed finish of the treatment with the gold-preparation. Cortisonoids are given for the acceleration of the remission. The prognosis is in general good. However, it depends on the fact, how long the gold treatment is still continued after the appearance of the pulmonary side-effect.