Gold induced hepatitis and pure red cell aplasia. Complete recovery after corticosteroid and N-acetylcysteine therapy.
A 54-year-old man developed severe cholestatic jaundice and pure red cell aplasia shortly after beginning treatment with gold sodium thiomalate. Although the hepatic toxicity began to spontaneously improve, the pure red cell aplasia was progressive. Treatment with prednisone and N-acetylcysteine (NAC) infusions was followed by prompt and complete hematologic recovery. Gold induced pure red cell aplasia should be added to the list of gold induced hematologic toxicities that can be potentially reversed with NAC infusion therapy.
Department of Medicine, Medical College of Wisconsin, Milwaukee 53226.
R M
RM
Hansen
R R
RR
Varma
G A
GA
Hanson
D000111:Acetylcysteine / Q000627:therapeutic use*; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D056486:Chemical and Drug Induced Liver Injury / Q000188:drug therapy* / Q000209:etiology; D006046:Gold / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D006505:Hepatitis / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D012010:Red-Cell Aplasia, Pure / Q000139:chemically induced* / Q000188:drug therapy*
D000305:Adrenal Cortex Hormones; D006046:Gold; D000111:Acetylcysteine