Adverse reactions of gold sodium thiomalate in rheumatoid arthritis patients in southern Iran

ABSTRACT

To confirm the side-effects of gold sodium thiomalate [GSTM], we carried out a retrospective study examining 102 consecutive patients with rheumatoid arthritis attending the Rheumatology Unit of Hafez Hospital, Shiraz, Iran, in whom GSTM was initiated between 1983-1989. Only patients with classical or definite RA [ARA criteria] were included in this study. Patients were categorized as having developed toxicity to gold if rash, stomatitis, leukopenia [<4000/mm3], thrombocytopenia [<100,000/mm3], anemia [Hb<10gm/dL], microscopic hematuria [more than 5 RBC in each HPF] and proteinuria [1+or more] appeared during chrysotherapy. Sixty-six [64.7%] patients developed adverse reactions. More significant side-effects were pruritus [57.8%], eosinophilia [23.5%], microscopic hematuria [20.5%], and low Hb [20.5%]. Inadequate primary response and relapses on therapy accounted for termination in 15.6% of patients, nephrotic syndrome in 0.9%, hepatitis in 1.9%, colitis in 2.9%, persistent pruritus in 1.9%, extensive lichenoid rash in 3.9%, persistent stomal ulcer in 0.9% and persistent hematuria in 1.9% of patients. Lichenoid rash was more significant and more extensive in our series compared to others