Nitritoid Reactions to Gold Treatment for Arthritis

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Abstract
To the Editor.— The side effects of gold sodium thiomalate therapy in the treatment of rheumatoid arthritis include dermatitis, stomatitis, nephritis (with or without proteinuria), and bone marrow depression (with or without eosinophilia). A less commonly mentioned side effect is the vasomotor or nitritoid reaction.1-3 During a one-month period, two patients with rheumatoid arthritis receiving gold therapy developed the nitritoid or vasomotor reaction. Following are their brief summaries. Report of Cases.—Case 1.— A 47-year-old white woman with a ten-year history of seronegative, nonnodular rheumatoid arthritis was first seen at the William Beaumont General Hospital Clinic, while she was receiving a maintenance dosage of gold sodium thiomalate, 50 mg every two weeks. Gold injections were given on (1) March 31, 1969, 50 mg, without reaction; (2) April 9, 50 mg, with mild nitritoid reaction; (3) May 7, 35 mg, without reaction; (4) May 23, 35 mg, with a mild

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