TREATMENT OF TWO REACTIONS DUE TO GOLD

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Abstract
The use of gold salts in the treatment of rheumatoid arthritis is not without danger. We have encountered an incidence of toxic reactions of about 20 per cent. Among the frequent reactions are dermatitis, stomatitis and glossitis. Those less frequent in our experience are colitis, albuminuria, hematuria, nephrosis. purpura and granulocytopenia. The treatment of the more serious reactions (nephrosis, exfoliative dermatitis, purpura and granulocytopenia) has been unsatisfactory,and fatalities have occurred in the past. Recently, when we encountered 2 reactions (thrombopenic purpura and granulocytopenia), it was decided to employ BAL (British Anti-Lewisite, 2,3-dimercaptopropanol), as this substance has been valuable in the treatment of other types of metallic poisoning (that due to arsenic and mercury). REPORT OF CASES Case 1.— A white man aged 34, who weighed 160 pounds (72.6 Kg.), was seen in November 1945 with rheumatoid arthritis, which had been present since February 1945. He was started on

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