aurotioprol and Arthritis--Rheumatoid

Gold salts are still a first choice for treatment of rheumatoid arthritis. Although adverse reactions are relatively frequent, hepatic abnormalities are rare. They consist largely of reversible cholestasis, and, exceptionally, the evolution can prove rapidly fatal due to extensive hepatic necrosis. We present an additional case of this kind which occurred after a total dose of 450 mg intramuscular Aurothiopropanol over 6 weeks. The pathogenetic mechanism is complex, toxic and/or immuno-allergic. Nevertheless, regular hepatic enzyme testing is not recommended.

Topics: Antirheumatic Agents; Arthritis, Rheumatoid; Chemical and Drug Induced Liver Injury; Dimercaprol; Gold; Humans; Liver; Male; Middle Aged; Necrosis; Organogold Compounds; Organometallic Compounds; Propanols; Sulfhydryl Compounds

Topics: Aged; Arthritis, Rheumatoid; Chorea; Dimercaprol; Female; Gold; Humans; Male; Metalloproteins; Middle Aged; Organogold Compounds; Organometallic Compounds; Propanols; Sulfhydryl Compounds

Analysis is made of the results of the treatment with parenteral (crysanol and myochrysine) and oral (ridaura) gold drugs as well as with small doses of D-penicillamine (DP) of patients suffering from rheumatoid arthritis with the signs of nephropathy. The latter ones were identified, respectively, in 18 out of 80 patients who began receiving treatment, in 17 out of 72, and in 16 out of 61 patients. The clinical, laboratory, instrumental and morphological manifestations of nephropathy are described and analysis of their dynamics under the treatment impact is provided. It is noted that these types of basic therapy produce a beneficial effect on the manifestations of rheumatoid nephropathy. That referred to a greater measure to the gold drugs than to the small doses of DP. The degree of counteracting the symptoms of renal pathology agreed well with a good clinical effect in respect to the articular syndrome and inflammatory responses of blood. Among patients receiving crysanol, iatrogenic nephropathy was recorded in 8.75% of cases, among those on ridaura, in 2.8%, and those on DP, in 8.2% of cases. The authors provide evidence for the use of gold drugs and DP in patients suffering from rheumatoid nephropathy.

Topics: Administration, Oral; Antirheumatic Agents; Arthritis, Rheumatoid; Auranofin; Dimercaprol; Drug Therapy, Combination; Gold Sodium Thiomalate; Humans; Injections; Kidney Diseases; Organogold Compounds; Organometallic Compounds; Penicillamine; Propanols; Prospective Studies; Sulfhydryl Compounds; Time Factors

A randomized study of 46 patients with classic and definite rheumatoid arthritis on chrysotherapy (25 patients--auranofin orally and 21--allochrysine intramuscularly) showed a therapeutic effect of both drugs. Allochrysine turned out more effective, it was not abandoned in any patients as a result of its inefficacy. However as compared to allochrysine auranofin was slightly better tolerated.

Topics: Administration, Oral; Adult; Anti-Inflammatory Agents, Non-Steroidal; Arthritis, Rheumatoid; Auranofin; Clinical Trials as Topic; Dimercaprol; Drug Tolerance; Female; Gold; Humans; Injections, Intramuscular; Male; Metalloproteins; Organogold Compounds; Organometallic Compounds; Propanols; Random Allocation; Sulfhydryl Compounds

Fifty patients with a significant rheumatoid arthritis (RA) were treated with gold salts for 6 months to 4 years. Patients with highly active conditions (stages II-III) and with erosive arthritis (stages IIb-IV) prevailed. Extraarticular manifestations were recognized in 76% of the patients. The efficacy of chrisanol given in a dose of 1.5 ml of a 5% solution was compared to that of myocrisin in a dose of 50 mg, i. e. 25 mg metallic gold once a week. The efficacy of the drugs was evaluated from their effects on the disease activity (clinical manifestations of the articular syndrome, ESR, morphological signs of rheumatoid synovitis) and progression (the rate of the development of erosive arthritis in hand and foot joints, the time course of serum RF content, and systemic disease manifestations). These characteristics were examined with the aid of modern ultrasonic and radionuclide research methods. The evaluations were made by the treatment onset and by months 3, 6, 12 and 18 of the treatment. Analysis of the data obtained attests to a high clinical efficacy of both the drugs exhibiting basic activity which is confirmed by a decrease in the degree of the morphological manifestations of synovitis and extraarticular signs of RA, particularly of myocarditis. A method for following up outpatients to prevent grave complications of chrysotherapy is offered.

Topics: Adolescent; Adult; Aged; Arthritis, Rheumatoid; Child; Clinical Trials as Topic; Dimercaprol; Drug Eruptions; Eosinophilia; Female; Gold; Gold Sodium Thiomalate; Humans; Leukopenia; Male; Middle Aged; Organogold Compounds; Organometallic Compounds; Propanols; Sulfhydryl Compounds

Study of the comparative efficacy of the basic slow-acting drugs for the treatment of rheumatoid arthritis permits considering randomization as necessary for obtaining objective data. It has been established that gold salts (chrisanol and myochrysin) are the most efficacious drugs for the treatment of RA. D-Penicillamine and delagil, in particular, are less efficacious. Administration of levamisole is rather dangerous because of the frequency and intensity of side effects.

Topics: Anti-Inflammatory Agents; Arthritis, Rheumatoid; Chloroquine; Clinical Trials as Topic; Dimercaprol; Gold; Gold Sodium Thiomalate; Humans; Levamisole; Organogold Compounds; Organometallic Compounds; Penicillamine; Propanols; Random Allocation; Sulfhydryl Compounds; Time Factors

Oral gold (auranofin) has been used in 31 patients, 20 with active rheumatoid arthritis and 11 with active psoriatic arthritis. In rheumatoid arthritis the oral gold treatment was compared to parenteral gold treatment in a patient blind trial for two years. The psoriatic arthritis cases were incorporated in an open trial. Auranofin 6 mg once daily reduced significantly the activity in rheumatoid arthritis and in psoriatic arthritis. The beneficial effect obtained with auranofin at a dose of 6 mg/day during the first year of treatment could not be maintained by 3 mg/day in the second year. Auranofin compared to parenteral gold had a distinct advantage of better systemic tolerability, although parenteral gold was found to be more potent. There was no greater risk for toxic skin reaction to oral gold in psoriatic arthritis than in rheumatoid arthritis. The overall conclusion of this longterm study is that oral gold (auranofin) 6 mg once daily, although slightly less effective than parenteral gold, can be considered to be the first choice of gold treatment for rheumatoid arthritis and psoriatic arthritis, because the compliance, which is a reflection of a combination of tolerance and efficacy, for oral gold therapy was, in our hands, undoubtedly superior to parenteral gold.

Topics: Adult; Anti-Inflammatory Agents; Arthritis; Arthritis, Rheumatoid; Auranofin; Aurothioglucose; Clinical Trials as Topic; Dimercaprol; Double-Blind Method; Female; Gold; Humans; Long-Term Care; Male; Middle Aged; Organogold Compounds; Organometallic Compounds; Patient Compliance; Propanols; Prospective Studies; Psoriasis; Random Allocation; Sulfhydryl Compounds

Hepatotoxicity, predominantly cholestatic, is a rare adverse effect of gold salt therapy, which usually completely resolves within a few months. We report the case of a female patient treated for rheumatoid arthritis, who had gold salt overdose, and in whom acute cholestatic hepatitis occurred three weeks after beginning of therapy. Evolution of gold concentration was followed in plasma and urine, as well as in cutaneous and liver dry tissue. Liver biopsy showed marked inflammatory changes of interlobular bile ducts that evolved towards ductopenia, which was responsible for prolonged cholestasis still present 15 months later. In addition, sialadenitis with sicca syndrome was noted six months after onset of the disease. The mechanism of hepatotoxicity was probably immunoallergic since liver lesions were associated with hypersensitivity syndrome including dermatitis and blood and tissue eosinophilia. This is the first report of gold salt hepatotoxicity with histological demonstration of cholangitis followed by ductopenia.

Topics: Antirheumatic Agents; Arthritis, Rheumatoid; Bile Duct Diseases; Biopsy; Chemical and Drug Induced Liver Injury; Cholangitis; Cholestasis, Intrahepatic; Dimercaprol; Female; Humans; Injections, Intramuscular; Liver; Middle Aged; Organogold Compounds; Organometallic Compounds; Propanols; Sulfhydryl Compounds

A subset of patients with rheumatoid arthritis occasionally develops skin reactions and glomerulonephritis and exhibits an increase in serum IgE concentration when treated with gold salts. Brown-Norway (BN) rats injected with aurothiopropanolsulfonate (ATPS) also manifest an autoimmune glomerulonephritis and increased serum IgE concentration, whereas Lewis (LEW) rats are resistant to complications. Here, we show linkage between responses to ATPS in a (BN x LEW) F2 cohort and the major histocompatibility complex (RT1) on rat chromosome 20 and between markers in the region of IL4 and other candidate genes on rat chromosome 10. Recently, human serum IgE concentration has been reported to be linked to the IL-4 region. Taken together, these findings raise the possibility that homologous genes could be implicated in ATPS manifestations in the rat and in the regulation of IgE levels in the human.

Topics: Animals; Antirheumatic Agents; Arthritis, Rheumatoid; Base Sequence; Crosses, Genetic; Dimercaprol; DNA Primers; Female; Genetic Linkage; Genetic Markers; Glomerulonephritis; Humans; Immunoglobulin E; Interleukin-4; Major Histocompatibility Complex; Male; Molecular Sequence Data; Organogold Compounds; Organometallic Compounds; Propanols; Rats; Rats, Inbred BN; Rats, Inbred Lew; Skin; Sulfhydryl Compounds

A study is presented of 34 patients with rheumatoid arthritis. The authors propose a method of persistently maintained aurotherapy of patients with rheumatoid arthritis directed to prevention of recurrences and toxic effect of gold due to chrysanol treatment, the active substance of which is metallic gold. After course treatment with chrysanol (850-1020 mg) persistent treatment by maintained doses is instituted.. prevention of recurrences of the disease and prevention of side effects due to the toxicity of cumulated gold.

Topics: Antirheumatic Agents; Arthritis, Rheumatoid; Dimercaprol; Feces; Female; Gold; Humans; Male; Middle Aged; Organogold Compounds; Organometallic Compounds; Propanols; Recurrence; Sulfhydryl Compounds; Time Factors

Topics: Antirheumatic Agents; Arthritis, Rheumatoid; Dimercaprol; History, 20th Century; Humans; Organogold Compounds; Organometallic Compounds; Propanols; Salts; Sulfhydryl Compounds

The author studied the content of corticotropin, cortisol, aldosterone, insulin in the blood serum of 69 patients with rheumatoid arthritis depending on the grade of activity of the inflammatory process before treatment in the course of aurotherapy within 12 months. It was established that in patients with rheumatoid arthritis changes develop in the system of pituitary-peripheral endocrine glands, namely, an increase of the concentration of corticotropin, aldosterone and a reduction of the level of cortisol and insulin indicating the participation of hormones in the pathogenesis of rheumatoid arthritis. Non-steroid antiinflammatory preparations and quinolinic derivatives did not effect the hormonal spectrum of rheumatoid arthritis. Prolonged aurotherapy resulted in a positive dynamics in the contents of hormones.

Topics: Adrenocorticotropic Hormone; Aldosterone; Antirheumatic Agents; Arthritis, Rheumatoid; Dimercaprol; Drug Evaluation; Drug Therapy, Combination; Female; Humans; Hydrocortisone; Insulin; Male; Metalloproteins; Organogold Compounds; Organometallic Compounds; Propanols; Sulfhydryl Compounds

From the analysis of literature and first-hand data on methylprednisolone pulse-therapy for rheumatoid arthritis (RA) the conclusion is made that such therapy produces a rapid and pronounced though short-term effect on the disease activity. It fails to stop RA progression. A case of two-wave effect is attributed to restoration of target cell sensitivity to chrysotherapy.

Topics: Antirheumatic Agents; Arthritis, Rheumatoid; Dimercaprol; Drug Therapy, Combination; Female; Humans; Methylprednisolone; Middle Aged; Organogold Compounds; Organometallic Compounds; Propanols; Sulfasalazine; Sulfhydryl Compounds

Topics: Antirheumatic Agents; Arthritis, Rheumatoid; Chronic Disease; Dimercaprol; Feces; Female; Gold; Humans; Male; Middle Aged; Organogold Compounds; Organometallic Compounds; Propanols; Sulfhydryl Compounds; Time Factors

Results are reported of changes of the level of lipid peroxidation in 51 patients with rheumatoid arthritis depending on the stage of activity of the inflammatory process and employment of non-steroid antirheumatic agents and gold preparations (crysanol). The authors discusses the problem of relative antioxidant insufficiency in rheumatoid arthritis and antioxidant properties of crysanol.

Topics: Adult; Anti-Inflammatory Agents, Non-Steroidal; Antioxidants; Antirheumatic Agents; Arthritis, Rheumatoid; Chronic Disease; Dimercaprol; Drug Therapy, Combination; Female; Humans; Lipid Peroxidation; Luminescent Measurements; Male; Metalloproteins; Middle Aged; Organogold Compounds; Organometallic Compounds; Propanols; Sulfhydryl Compounds

Topics: Antirheumatic Agents; Arthritis, Rheumatoid; Dimercaprol; Female; Humans; Metalloproteins; Middle Aged; Organogold Compounds; Organometallic Compounds; Propanols; Pulmonary Fibrosis; Sulfhydryl Compounds

Patients with rheumatoid arthritis showed changes of the fatty acid spectrum manifested in a reduction of the polyunsaturated acids (linoleic, linolenic, arachidonic) and an increase of the level of monounsaturated (oleic, palmithooleinic) depended on the course of the disease. Antirheumatic treatment produced a positive effect, especially gold preparations, on normalization of the level of unsaturated fatty acids in rheumatoid arthritis.

Topics: Adrenal Cortex Hormones; Adult; Anti-Inflammatory Agents, Non-Steroidal; Antirheumatic Agents; Arthritis, Rheumatoid; Chromatography, Gas; Chronic Disease; Dimercaprol; Drug Therapy, Combination; Fatty Acids, Unsaturated; Humans; Metalloproteins; Middle Aged; Organogold Compounds; Organometallic Compounds; Propanols; Sulfhydryl Compounds

Topics: Adolescent; Adult; Ambulatory Care; Arthritis, Juvenile; Arthritis, Rheumatoid; Dimercaprol; Female; Humans; Injections, Intra-Articular; Male; Metalloproteins; Middle Aged; Organogold Compounds; Organometallic Compounds; Propanols; Solutions; Sulfhydryl Compounds

Topics: Anemia, Aplastic; Antirheumatic Agents; Arthritis, Rheumatoid; Dimercaprol; Female; Humans; Metalloproteins; Middle Aged; Organogold Compounds; Organometallic Compounds; Propanols; Sulfhydryl Compounds; Time Factors

Three patients receiving gold salt treatment for rheumatoid arthritis developed severe aplastic anemia. All three patients experienced remission of their disease at the time of the occurrence of marrow aplasia. Reviewing data on these patients and recent literature indicate that fatal marrow aplasia seems to occur more frequently in sero-negative women who respond well to therapy with gold salts. Frequent blood monitoring in search for any pronounced or sustained drop in red, white or platelet count, even within normal range could serve as a warning sign for myelotoxicity. Despite intensive supportive measures and specific therapeutic attempts, all three patients eventually died of septic shock.

Topics: Adult; Aged; Anemia, Aplastic; Arthritis, Rheumatoid; Dimercaprol; Female; Humans; Metalloproteins; Middle Aged; Organogold Compounds; Organometallic Compounds; Propanols; Shock, Septic; Sulfhydryl Compounds

Extensive immunological investigations were performed in a patient with definite seronegative rheumatoid arthritis who developed hypogammaglobulinemia in the course of gold therapy. The data obtained suggest the presence of acquired maturation abnormalities in the B cell compartment.

Topics: Agammaglobulinemia; Anti-Inflammatory Agents; Arthritis, Rheumatoid; B-Lymphocytes; Dimercaprol; Humans; Lymphocyte Activation; Male; Metalloproteins; Middle Aged; Organogold Compounds; Organometallic Compounds; Propanols; Steroids; Sulfhydryl Compounds

The authors observed the development of herpes zoster in 2 rheumatoid arthritic patients against a background of chrysanol therapy. Such a complication should be regarded as an indication for aurum drug cancellation. The study provided an opportunity for specifying some aspects in the mechanism of action and indicated a possible immunodepressive effect.

Topics: Arthritis, Rheumatoid; Dimercaprol; Female; Herpes Zoster; Humans; Metalloproteins; Middle Aged; Organogold Compounds; Organometallic Compounds; Propanols; Sulfhydryl Compounds

Titers of circulating antigalactosyl antibodies (a-Gal Ab) were assessed by passive hemagglutination using rabbit red blood cells in 40 normal subjects, in 14 patients with immunodeficient states, in 47 patients with active rheumatoid arthritis (RA), and in 15 patients with an Henoch-Schönlein disease (HS). Titers of controls ranged from 1:16 to 1:64. All immunodeficient patients exhibited very low titers (1:1). On the contrary, the existence of an enhanced humoral immune response status, as observed in RA, was not reflected by a parallel increase of a-Gal Ab titers. However, in this disease, a strong relationship existed between titers exceeding control values (greater than 1:64) and the prior occurrence of renal injury under gold or D-penicillamine therapy. Lastly, the discovery of elevated titers (greater than 1:64) in HS only when renal involvement occurred further suggests that such antibodies reflect a renal injury.

Topics: Acquired Immunodeficiency Syndrome; Adolescent; Adult; Aged; Antibody Formation; Antibody Specificity; Arthritis, Rheumatoid; Child; Child, Preschool; Dimercaprol; Female; Gold; Hemagglutination Tests; Humans; IgA Vasculitis; Immune Complex Diseases; Immunoglobulin G; Infant; Kidney; Kidney Diseases; Male; Middle Aged; Multiple Myeloma; Organogold Compounds; Organometallic Compounds; Penicillamine; Propanols; Sulfhydryl Compounds

Topics: Arthritis, Rheumatoid; Chorea; Dimercaprol; Female; Humans; Leg; Metalloproteins; Middle Aged; Myoclonus; Organogold Compounds; Organometallic Compounds; Propanols; Sulfhydryl Compounds; Syndrome

Topics: Aged; Anti-Inflammatory Agents; Arthritis, Rheumatoid; Blood Transfusion; Dimercaprol; Female; Gold; Humans; Organogold Compounds; Organometallic Compounds; Pancytopenia; Platelet Transfusion; Propanols; Sulfhydryl Compounds

Topics: Arthritis, Rheumatoid; Chorea; Dimercaprol; Female; Gold; Humans; Leg; Middle Aged; Myoclonus; Organogold Compounds; Organometallic Compounds; Polyradiculoneuropathy; Propanols; Sulfhydryl Compounds; Syndrome

It is suggested by many tests that phagocytic cells were implied in inflammation which occurred during rheumatoid arthritis (RA). Further, three subject populations were selected for this study: Rheumatoid arthritis patients diagnosed according to American Rheumatism Association criteria (ARA mean = 6) and treated with gold compounds. Control subjects treated with the same non-steroidal anti-inflammatory drug (NSAID), diclofenac (75 mg per day). Normal subjects without disease or treatment. Blood granulocytes and monocytes were separately tested for ingestion of three different particle species (opsonized zymosan, immunoglobulin G sheep red cells, glutaraldehyde-treated sheep red cells) and stimulation of superoxide anion production by these particles. All phagocytic cells in RA patients have normal phagocytic response and superoxide anion production. Autologous serum does not inhibit the activity of these cells. In addition the NSAID (diclofenac) does not act upon phagocytosis and oxidative burst of control cells.

Topics: Adolescent; Adult; Aged; Animals; Anions; Arthritis, Rheumatoid; Cattle; Diclofenac; Dimercaprol; Glutaral; Gold; Granulocytes; Humans; Immunoglobulin G; In Vitro Techniques; Middle Aged; Monocytes; Organogold Compounds; Organometallic Compounds; Phagocytosis; Propanols; Rabbits; Sheep; Sulfhydryl Compounds; Superoxides; Zymosan

One hundred and forty-one patients with rheumatoid arthritis treated with aurothiopropanol sulphonate or D-penicillamine, or both were examined for HLA antigens to investigate the genetic influence on the occurrence of different adverse reactions during therapy. All 13 patients possessing HLA-DR3 had toxic reactions. The relative risk for DR3 positives of developing skin eruptions or proteinuria was calculated to be 10.5 times and seven times respectively that of DR3 negatives. The incidence of DR7 antigen in 94 patients with toxic reactions was significantly decreased (11% compared with 28% in controls) suggesting a protective role for this antigen.

Topics: Adult; Aged; Anti-Inflammatory Agents; Arthritis, Rheumatoid; Dimercaprol; Female; Gold; Histocompatibility Antigens Class II; HLA Antigens; HLA-A Antigens; HLA-B Antigens; HLA-DR3 Antigen; Humans; Male; Middle Aged; Organogold Compounds; Organometallic Compounds; Penicillamine; Propanols; Sulfhydryl Compounds

Topics: Aged; Arthritis, Rheumatoid; Dimercaprol; Gold; Humans; Male; Organogold Compounds; Organometallic Compounds; Propanols; Pulmonary Fibrosis; Sulfhydryl Compounds; Therapeutic Irrigation

One hundred sixty-two consecutive patients with rheumatoid arthritis (RA) were studied for possible association between HLA antigens, particularly DR antigens, and disease characteristics and adverse reactions to gold or D-penicillamine treatment. The frequency of HLA-DR4 was significantly increased: 62% in RA compared to 23% in controls. An association of HLA-DR4 with a positive family history for RA was also found. HLA-DR4 was not associated with subcutaneous nodules or keratoconjunctivitis, presence of rheumatoid factor, or ANA positivity. No increased prevalence of HLA-DR3 was found in patients who developed drug related toxicity (e.g., proteinuria for gold or D-penicillamine). Of the 27 patients in whom proteinuria developed, only 5 were DR3 positive. A significant association with D-penicillamine induced proteinuria and HLA-B8 gene was found. Our results obtained in a systematic survey do not confirm previous reports of a significant association between HLA-DR3 and drug toxicity, but confirm the association between HLA-DR4 and the development of RA and HLA-B8 and D-penicillamine induced proteinuria.

Topics: Adolescent; Adult; Aged; Arthritis, Rheumatoid; Cytotoxicity Tests, Immunologic; Dermatitis; Dimercaprol; Drug Tolerance; Female; Fluorescent Antibody Technique; Gold; Hematuria; Histocompatibility Antigens Class II; HLA Antigens; HLA-A Antigens; HLA-B Antigens; HLA-C Antigens; HLA-DR Antigens; Humans; Male; Middle Aged; Organogold Compounds; Organometallic Compounds; Penicillamine; Propanols; Proteinuria; Stomatitis; Sulfhydryl Compounds

Topics: Adult; Arthritis, Rheumatoid; Dimercaprol; Female; Gold; Humans; Organogold Compounds; Organometallic Compounds; Propanols; Pulmonary Fibrosis; Sulfhydryl Compounds; Toes; Vasculitis

Topics: Adult; Arthritis, Rheumatoid; Colitis; Dimercaprol; Female; Gold; Humans; Organogold Compounds; Organometallic Compounds; Propanols; Sulfhydryl Compounds

Topics: Adult; Aged; Arthritis, Rheumatoid; Dimercaprol; Dysgammaglobulinemia; Female; Gold; Humans; IgA Deficiency; Middle Aged; Organogold Compounds; Organometallic Compounds; Penicillamine; Propanols; Retrospective Studies; Sulfhydryl Compounds

Topics: Adult; Anti-Inflammatory Agents; Arthritis, Rheumatoid; Dimercaprol; Dose-Response Relationship, Drug; Female; Gold; Humans; Injections, Intra-Articular; Male; Middle Aged; Organogold Compounds; Organometallic Compounds; Propanols; Sulfhydryl Compounds

Among 67 patients with rheumatoid arthritis treated with gold salts (aurothiopropanol sulphonate) a significant correlation (p less than 10(-2)) was noted between gold toxic reactions, whatever their type, and the HLA antigens A1, B8, Cw7, and DR3. Forty-two patients were genotyped, and a correlation was observed between gold side effects and the haplotype A1 Cw7 B8 DR3 (p less than 10(-2), RR = 8.0). In addition 3 out of 4 cases of renal intolerance to D-penicillamine were observed in patients possessing the Cw7 B8 DR3 haplotype.

Topics: Adult; Aged; Arthritis, Rheumatoid; Dimercaprol; Female; Gold; Histocompatibility Antigens Class II; HLA Antigens; HLA-DR Antigens; Humans; Male; Middle Aged; Organogold Compounds; Organometallic Compounds; Penicillamine; Propanols; Sulfhydryl Compounds

Topics: Adult; Arthritis, Rheumatoid; Chemical and Drug Induced Liver Injury; Dimercaprol; Drug Therapy, Combination; Gold; Humans; Indomethacin; Male; Organogold Compounds; Organometallic Compounds; Propanols; Sulfhydryl Compounds

Ultrastructural investigation of bone marrow cells of histiocytic lineage to determine the presence of microcrystals containing gold was carried out in 12 patients. Eleven patients had classical or definite rheumatoid arthritis and one had palindromic rheumatism; the duration of these diseases ranged from 6 months to 10 years. Two patients had never received chrysotherapy and therefore served as controls. The remaining 10 patients had been treated with sodium aurothiopropanolsulfonate for periods ranging from 1 week to 4 years and 4 months without any clinical signs of laboratory findings--hematological changes in particular--of drug intolerance. No crystalline structures could be found in the 2 controls or in the patient who had just begun treatment. Conversely, in the 9 other patients, the lysozymes of bone marrow macrophages contained needle-like microcrystals containing one atom of gold for two atoms of sulfur, i.e. identical in proportion to the injected product. For equivalent total doses, deposits appeared to be equally numerous regardless of the time span between the last injection and the sampling (2-21 months). These crystals were present in the bone marrow several years after the beginning of chrysotherapy. The actual mechanism of their precipitation remains unknown at present.

Topics: Adult; Aged; Arthritis, Rheumatoid; Bone Marrow; Dimercaprol; Female; Gold; Humans; Lysosomes; Macrophages; Male; Middle Aged; Organogold Compounds; Organometallic Compounds; Propanols; Sulfhydryl Compounds

Topics: Adult; Arthritis, Rheumatoid; Capillary Permeability; Cell Membrane Permeability; Dimercaprol; Drug Therapy, Combination; Female; Gold; Humans; Ibuprofen; Immunosuppressive Agents; Indomethacin; Male; Middle Aged; Organogold Compounds; Organometallic Compounds; Propanols; Sulfhydryl Compounds; Synovial Membrane

In inflammatory rheumatism treated by gold therapy synoviocytes A are stuffed with gold salt deposits leading to a therapeutic thesaurismosis. These deposits are localized in lysosomes, then called aurosomes. However they may be rarely near collagen fibers or free, particularly in ankylosing spondylitis synovitis. Their structural morphological aspect is the same in several human rheumatic diseases and in rabbit experimental arthritis whatever the gold salt used. In such deposits, microprobe analysis shows gold and sulphur. This latter is probably given by the cell. Therapeutic effect of gold salts may imply the effect of the thiol moiety and the gold metal one.

Topics: Adult; Animals; Arthritis, Rheumatoid; Dimercaprol; Female; Gold; Humans; Male; Microscopy, Electron; Middle Aged; Organogold Compounds; Organometallic Compounds; Propanols; Rabbits; Sulfhydryl Compounds; Synovial Membrane

Topics: Adult; Arthritis, Rheumatoid; Dimercaprol; Female; Gold; Humans; Injections, Intramuscular; Male; Organogold Compounds; Organometallic Compounds; Propanols; Sulfhydryl Compounds; Suspensions; Time Factors

Topics: Arthritis; Arthritis, Rheumatoid; Drug Therapy; Eosinophilia; Gold; Humans; Organogold Compounds; Pneumonia; Propanols; Pulmonary Eosinophilia; Sulfhydryl Compounds; Toxicology