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  • Title: [Fatal hepatic necrosis due to a treatment course of rheumatoid arthritis with gold salts].
    Author: Van Linthoudt D, Buss W, Beyner F, Ott H.
    Journal: Schweiz Med Wochenschr; 1991 Jul 27; 121(30):1099-102. PubMed ID: 1678206.
    Abstract:
    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.
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