Pulmonary Reaction to Chrysotherapy

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Abstract
To the Editor: Winterbauer et al. (N Engl J Med 294:919–921, 1976) present convincing evidence that chrysotherapy may induce diffuse pulmonary injury. We wish to re-emphasize two commonly accepted precautions in the use of chrysotherapy, pertinent to the cases reported.Phenylbutazone and gold sodium thiomalate were given concomitantly in Case 1. A number of authorities1 2 3 state that pyrazolon-derived drugs (phenylbutazone, oxyphenbutazone) are interdicted during chrysotherapy. Both drugs produce bone-marrow suppression and aplasia, and one drug may enhance the toxic potential of the other.3 Furthermore, the causative agent cannot be identified if mucocutaneous lesions develop during combined drug treatment, and . . .

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