Author/Editor		Mušič, E; Tomšič, M; Logar, D
Title		Gold salt alveolitis in 3 patients with rheumatoid arthritis
Translated title		Goldsalzalveolitis bei drei Patienten mit rheumatoider Arthritis
Type		članek
Source		Pneumologie
Vol. and No.		Letnik 49, št. 6
Publication year		1995
Volume		str. 367-72
Language		eng
Abstract		BACKGROUND: When the characteristic symptoms for an interstitial pulmonary disease arise in patients with rheumatoid arthritis, a drug-induced alveolitis should be considered in the differential diagnosis. In such cases, the administration of the drug and gold salts should be stopped. PATIENTS AND METHODS: The cases of three patients with rheumatoid arthritis (RA) who had been treated with gold salts for 2 months (A), 23 months (B), and 36 months (C) are presented. The total dose of sodium aureothiomalate amounted to 280 mg for patient A, 1150 mg for patient B, and 2190 mg for patient C. Clinical signs, X-rays of the lungs, pulmonary function tests, and laboratory tests were evaluated for the three patients while, for patient A BAL as well as provocation tests were additionally performed before and after therapy. In this case, the histological picture of the lungs is presented; biopsies were taken during the first BAL. RESULTS: The clinical complaints of all 3 patients were similar, with the alveolitis being observed as diffuse in one case and above all in the upper regions in two cases on radiology. This led to differing degrees of diffusion disorders in the lungs. In patient A, the diagnosis was made in the stage of progressive fibrotic alveolitis and was treated with D-penicillamine. All 3 patients received steroids over 3-6 months and the gold salts were stopped. Because of the long duration and doubtful differential diagnosis for patient A with either rheumatoid lung or gold salt alveolitis, a provocation test with sodium aureothiomalate was performed. All 3 patients had blood eosinophilia while, in case A, a thrombopenia was also found. CONCLUSIONS: A gold salt alveolitis can occur as a side effect of gold salts in addition to skin vasculitis and hematological disorders. When the gold salt administration is not stopped a fibrotic alveolitis can develop.(trunc.)
Descriptors		ARTHRITIS, RHEUMATOID AURANOFIN GOLD SODIUM THIOMALATE PULMONARY FIBROSIS AGED AURANOFIN BIOPSY BRONCHOALVEOLAR LAVAGE FLUID GOLD SODIUM THIOMALATE MIDDLE AGE PULMONARY ALVEOLI PULMONARY FIBROSIS