Thrombocytopenia associated with auranofin therapy: Evidence for a gold‐dependent immunologic mechanism

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Abstract
Thrombocytopenia associated with gold therapy is thought to be due to an immunemediated mechanism. Relatively few patients have been studied so far, and precise details of the pathophysiology of this disease remain undetermined. We report a patient with gold‐induced thrombocytopenia resulting from auranofin therapy. The patient's plasma contained platelet‐reactive antibodies detectable only in the presence of gold salts. Antibody binding occurred at gold concentrations ranging from 0.01 to 10,000 ng/ml. The binding occurred independently of gold salt used, suggesting that substitution of a different gold preparation in this patient would result in a similar thrombocytopenia. These data support a drug‐dependent immune mechanism for platelet destruction.