title: Rheumatoid arthritis, gold therapy, contact allergy and blood cytokines.
abstract: OBJECTIVE
  To study the clinical and biochemical effects of a low starting dose for gold therapy in rheumatoid arthritis patients with a contact allergy to gold.
  
  
  METHODS
  Serum cytokines were assayed before and 24 h after the first injection of gold sodium thiomalate (GSTM).
  
  
  RESULTS
  Contact allergy to gold was found in 4 of 19 patients. Compared to gold-negative patients (starting dose: 10 mg GSTM), there was a larger increase in serum TNFalpha (p < 0.05), sTNF-R1 (NS), and IL-1 ra (p < 0.05) in gold-allergic patients.
  
  
  CONCLUSIONS
  Cytokines are released in blood by GSTM in RA patients with gold allergy. To minimize the risk of acute adverse reactions the starting dose of GSTM should be lowered to 5 mg. Alternatively, patients should be patch-tested before gold therapy; in test-positive cases, 5 mg is recommended as the first dose.
authors.affiliation: Department of Dermatology, Malmö University Hospital, Sweden. ake.svensson@skane.se
authors.forename: Ake
authors.initials: A
authors.lastname: Svensson
authors.forename: Halvor
authors.initials: H
authors.lastname: Möller
authors.forename: Bert
authors.initials: B
authors.lastname: Björkner
authors.forename: Magnus
authors.initials: M
authors.lastname: Bruze
authors.forename: Ido
authors.initials: I
authors.lastname: Leden
authors.forename: Jan
authors.initials: J
authors.lastname: Theander
authors.forename: Kjell
authors.initials: K
authors.lastname: Ohlsson
authors.forename: Carina
authors.initials: C
authors.lastname: Linder
mesh_terms: D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000008:administration & dosage* / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000276:immunology; D001831:Body Temperature; D016207:Cytokines / Q000097:blood*; D017449:Dermatitis, Allergic Contact / Q000209:etiology* / Q000276:immunology; D005260:Female; D006052:Gold Sodium Thiomalate / Q000008:administration & dosage* / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D018501:Antirheumatic Agents; D016207:Cytokines; D006052:Gold Sodium Thiomalate