DIFFUSE PULMONARY INJURY ASSOCIATED WITH GOLD TREATMENT

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Abstract
A patient showing a Au-induced diffuse pulmonary reaction is described. An open lung biopsy specimen showed thickening of alveolar septa due to inflammation. The alveolar walls were lined by cuboidal epithelium. On EM examination electron-dense structures were observed within lysosomes of endothelial cells of the alveolar capillaries and interstitial macrophages. Electron probe microanalysis showed that these structures contained Au. The Au accumulation in endothelial cells and macrophages and a direct toxic effect might be an important feature in the pathogenesis of Au-induced pulmonary reactions. The Au accumulation may reflect exposure rather than disease. Au is used to treat arthritis.