[Fatal hepatic necrosis due to a treatment course of rheumatoid arthritis with gold salts].
Gold salts are still a first choice for treatment of rheumatoid arthritis. Although adverse reactions are relatively frequent, hepatic abnormalities are rare. They consist largely of reversible cholestasis, and, exceptionally, the evolution can prove rapidly fatal due to extensive hepatic necrosis. We present an additional case of this kind which occurred after a total dose of 450 mg intramuscular Aurothiopropanol over 6 weeks. The pathogenetic mechanism is complex, toxic and/or immuno-allergic. Nevertheless, regular hepatic enzyme testing is not recommended.
Van Linthoudt
D
D
Service de rhumatologie, Hôpital communal, La Chaux-de-Fonds.
Buss
W
W
Beyner
F
F
Ott
H
H
D018501:Antirheumatic Agents / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology*; D004112:Dimercaprol / Q000009:adverse effects* / Q000627:therapeutic use; D006046:Gold / Q000009:adverse effects; D006801:Humans; D008099:Liver / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D050607:Organogold Compounds; D009942:Organometallic Compounds / Q000009:adverse effects* / Q000627:therapeutic use; D020005:Propanols; D013438:Sulfhydryl Compounds
D018501:Antirheumatic Agents; D050607:Organogold Compounds; D009942:Organometallic Compounds; D020005:Propanols; D013438:Sulfhydryl Compounds; D004112:Dimercaprol; D006046:Gold; C013394:aurotioprol
Nécrose hépatique fatale au cours d'un traitement aux sels d'or d'une polyarthrite rhumatoïde.