Gibbons R B
Arch Intern Med. 1979 Mar;139(3):343-6.
Chrysotherapy has become a cornerstone in the treatment program of patients with rheumatoid arthritis. Unfortunately, approximately one third of these individuals will experience an adverse drug reaction at some time. Cutaneous manifestations are most commonly recognized and do not necessarily preclude reinstitution of gold after their resolution. Other complications involving the hematopoietic and renal systems are less frequent but may be severe. Recently, investigators have described serious toxic reactions involving the liver and lungs. The pathophysiologic mechanism of these untoward effects appears to be immunologic, although there are conflicting data. Treatment is primarily supportive, and the role of corticosteroids and chelating agents remains controversial. Emphasis should be placed primarily on early detection of adverse reactions through patient education and careful monitoring of blood and urine values.
金疗法已成为类风湿性关节炎患者治疗方案的基石。不幸的是，这些患者中约有三分之一会在某个时候出现药物不良反应。皮肤表现最为常见，消退后不一定排除重新使用金制剂。涉及造血系统和肾脏系统的其他并发症较少见，但可能很严重。最近，研究人员描述了涉及肝脏和肺部的严重毒性反应。尽管存在相互矛盾的数据，但这些不良反应的病理生理机制似乎是免疫性的。治疗主要是支持性的，皮质类固醇和螯合剂的作用仍存在争议。应主要通过患者教育以及对血液和尿液值的仔细监测，重点关注不良反应的早期检测。
