Injectable gold dermatitis and proteinuria: retreatment with auranofin

Int J Clin Pharmacol Res. 1985;5(4):265-8.

Abstract

Seven female patients with classical rheumatoid arthritis (RA), treated successfully with injectable gold salts (Fosfocrisolo ICI, 0.10 g/week, with a serum gold concentration of 200-400 mcg/dl), experienced severe gold side-effects after 3 to 20 months of therapy, requiring their withdrawal from gold despite the good results in both clinical and laboratory findings. Four patients showed mucocutaneous side-effects (2 dermatitis and 2 stomatitis) and three a moderate or severe proteinuria. Renal biopsy was performed in these patients, with a histological picture of membranous glomerulonephritis referable to gold therapy. Remission inducing drug (R.I.D.) therapy being mandatory in patients with a chronic progressive disease, and in view of the previous efficacy of gold salts, the patients were put on oral gold, Auranofin being administered 3 mg b.i.d. Both the mucocutaneous side-effects and the proteinuria ameliorated within 2 to 6 months, and the remission of the disease was maintained. The chemical and pharmacokinetic differences between the above two gold compounds are discussed.

MeSH terms

  • Adult
  • Arthritis, Rheumatoid / drug therapy*
  • Auranofin
  • Aurothioglucose / analogs & derivatives*
  • Aurothioglucose / therapeutic use
  • Drug Eruptions / etiology*
  • Female
  • Glomerulonephritis / chemically induced
  • Glomerulonephritis / drug therapy
  • Gold / adverse effects*
  • Gold / analogs & derivatives*
  • Gold / therapeutic use
  • Humans
  • Middle Aged
  • Proteinuria / chemically induced*

Substances

  • Aurothioglucose
  • Auranofin
  • Gold