Stručni rad
Side-effects in gold treatment
T. Dürrigl
; Centralna reumatološka stanica, Zagreb
Sažetak
In our series of 80 patients suffering from rheumatoid arthritis and treated with gold-salts the side-effects have been observed and analyzed. The results obtained are compared with data from literature. The symptoms of the basic disease growing worse in the sense of the exacerbation of the rheumatic process, which usually occurs at the beginning of the treatment but may appear also later, arc regarded as »the reaction to aurotherapy«. In one case they manifested themselves in a serious general clinical picture. Side-effects manifest themselves on the skin, on the mucous membranes, on the kidneys, on the nervous system and in the blood, and should always be met with caution; it is often necessary to discontinue aurotherapy or lo apply a special treatment. But there are several gradations and all side-effects are not equally heavy. In pruritus, a light itching, appearing gradually and usually ceasing when the dose of gold is reduced, is to be distinguished from a sudden, intense itching which is often an alarm for an: imminent dermatitis. Dermatitis was observed in four patients. Relatively frequent is a bitter metallic taste in the mouth, which usually ceases spontaneously; gingivitis was observed only in two patients. Temporary aches in the stomach or heart-burning do not indicate a serious danger, except for gastroduodenal ulcus in which case aurotherapy is not indicated. Side-effects on the kidney are not frequent but may be serious: in one case it came to a transitory slight albuminuria and cilindruria. The most serious side-effects may occur in the blood. Three heavy leucopenias, seven thrombopenias (in two cases they were combined) and two slight purpuras were recorded. In such cases the treatment must be discontinued immediately. Eosinophilia is a frequet sign of an approaching danger. All side-effects recorded passed and there were no permanent injuries. In 62.5% of the patients aurotherapy was fully applied, while in 32.5% it was discontinued on account of side-effects due to gold. Heavier side-effects require a special treatment: application of calcium and Vitamin C, corticosteroids, ACTH and BAL, which was applied in three patients with good results. Great importance is attached to the prevention of side-effects. For this purpose a regular control of the skin and mucous membranes is necessary, as well as regular laboratory examinations of the blood and urine. In addition, all patients were given vitamin C per is in doses of 2 g a day. The dose of gold should be increased gradually and cautiously. A small number of more serious side-effects shows that gold, under the precautions set forth, can successfully be applied in the therapy of rheumatoid arthritis. It is essential that the early signs of intolerance should be discovered in time and treated immediately, by which any danger for the patient is avoided.
Ključne riječi
Hrčak ID:
183149
URI
Datum izdavanja:
19.3.1959.
Posjeta: 942 *