D-penicillamine as a treatment for toxic reactions to gold therapy

✍ Scribed by Majda I. Khoury

• Publisher: John Wiley and Sons
• Year: 1986
• Tongue: English
• Weight: 132 KB
• Volume: 29
• Category: Article
• ISSN: 0004-3591
• DOI: 10.1002/art.1780290325

✦ Synopsis

LETTERS D-penicillamine as a treatment for toxic reactions to gold therapy

To the Editor:

The report by Gambari et a1 (1) describing neurotoxicity occurring in a patient after taking a very high dose of oral gold presents 2 interesting problems. First, with the use of oral administration of gold (auranofin), the clinician should be alerted to the possibility of "overdose," which, with parenteral treatment, has thus far been an unlikely problem. Second, the proper course of action in treating such a condition remains to be determined.

The authors chose to treat their patient with Dpenicillamine (DP), which as they stated, "some . . . consider to be effective in the treatment of gold toxicity." However, the reference they cite in support of this assertion (2) contains no such inference. At the conclusion of his article, Lyle states that "it [penicillamine] is of doubtful or no value for cadmium, mercury, and gold intoxication." A putative role for DP in the treatment of toxic reactions to gold relates to its properties as a chelating agent for heavy metals. The question is whether DP chelates antiarthritic gold compounds and auranofin in particular. The gold atom exists in 2 oxidation states in aqueous media,