Reinstitution of gold after gold induced proteinuria.
OBJECTIVE
To assess the benefits and risks to patients who resumed gold after discontinuation of gold because of proteinuria.


METHODS
We conducted a review of records of all patients who had resumed gold after discontinuing treatment because of proteinuria.


RESULTS
Eight patients developed proteinuria > or = 500 mg/dl while receiving 50 mg weekly doses in the first year of treatment. Proteinuria took a minimum of 4 mo to resolve. No patient had a recurrence of proteinuria when gold was resumed at a lower dosage of 25 mg every 1-2 weeks. This strategy has been successful in 5/8 patients who continue taking gold and are markedly improved compared to pretreatment status after 3-7 years (mean 5 years) of followup.


CONCLUSIONS
The risk of gold induced proteinuria may be dose related and reinstitution of gold at a lower dose is safe in our experience and effective in selected patients.
Klinkhoff
A V
AV
Division of Rheumatology, University of British Columbia and The Mary Pack Arthritis Centre, Vancouver, Canada.
Teufel
A
A
D000368:Aged; D001168:Arthritis / Q000188:drug therapy*; D004334:Drug Administration Schedule; D005260:Female; D006052:Gold Sodium Thiomalate / Q000008:administration & dosage* / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011507:Proteinuria / Q000139:chemically induced*
D006052:Gold Sodium Thiomalate