Hepatotoxicity with aurothioglucose therapy

✍ Scribed by Peter J. Lowthian; Dr. Leslie G. Cleland; Barrie Vernon-Roberts

• Publisher: John Wiley and Sons
• Year: 1984
• Tongue: English
• Weight: 291 KB
• Volume: 27
• Category: Article
• ISSN: 0004-3591
• DOI: 10.1002/art.1780270217

✦ Synopsis

Gold-induced hepatotoxicity has been seen infrequently in studies of patients receiving chrysotherapy (1,2). Although there was an early report describing hepatitis in 9.4% of patients, the authors did not distinguish cases of infectious hepatitis (3). Reported inducing agents include gold sodium thiomalate (4-8) and sodium aurothiopropranol sulfonate (9), to which our report adds aurothioglucose. Each of these compounds contains an auro-thio (Au-S-) group, although their chemical compositions differ otherwise.

Case report. A 43-year-old woman presented in January 1982 with active seropositive (Rose-Waaler titer 1 : 2,048), nonerosive rheumatoid arthritis. Recently introduced betamethasone treatment, 1.5 mg/day , was withdrawn. Indomethacin suppositories were tried briefly but were not tolerated due to rectal discomfort. Aurothioglucose injections were commenced with an initial dose of 10 mg, followed by 20 mg and 50 mg doses at intervals of 4 days. At the same time, she commenced taking naproxen 750 mg/day.

Fourteen days after the first injection, she developed painful cervical lymphadenopathy. On the following day, she received 50 mg aurothioglucose