Study on the conbined therapy of spa and gold salt in rheumatoid arthritis Part II. An experience of granulocytopenia possibly caused by gold salt preparation

Abstract

A thirty seven years old woman with rheumatoid arthritis was instituted gold salt intramuscularly twice a week on the nineteenth hospital day. On the fifty fourth day, however, it was discontinued at the total dosis of 180 mg because of the skin rush. In about ten days after stopping gold injection appeared high fever with shivering and granulocytopenia was demonstrated. With immediate administration of ACTH, adrenocortical hormons etc. including blood transfusion the abnormal findings of the blood pictures returned to normal and the patient became well. Recently, gold salts are so widely used in treatment of rheumatoid arthritis as one of specific antirheumatic agents that the possible severe side effect such as granulocytopenia, if quite rare, should always be considered in the course of gold therapy