Inhibition of mycoplasma-induced lymphocyte activation by sodium aurothiomalate

Gold therapy in the management of juvenile rheumatoid arthritis

Gold therapy for 6 months was shown to be efficacious in reducing the severity of articular manifestations in 32 (63%) of 51 juvenile rheumatoid arthritis patients reviewed retrospectively. Similarly, reductions in the total number of involved joints were seen in 25 (49%) patients. Patients in whom a favorable response to therapy was noted had more severe joint involvement at the start of therapy than did nonresponders. In general, patients who responded experienced considerable improvement. Duration of disease prior to gold therapy initiation and disease onset type were not related to the probability of favorable response. Incidence of adverse side effects was low. Gold has recently been approved by the Food and Drug Administration for use in children.

Inhibition of reticuloendothelial function by gold and its relation to postinjection reactions

A patient with rheumatoid arthritis developed severe exacerbation of symptoms 18 hours after an injection of gold thiomalate (sodium aurothiomalate). Immune complexes were present in his serum and synovial fluid; in the synovial fluid they were associated with intense complement activation. The effect of gold salts on splenic reticuloendothelial function was determined by measuring the clearance of heat-damaged erythrocytes from the circulation. Gold thiomalate (50 mg) substantially delayed clearance in the patient but had no effect in four other patients with rheumatoid arthritis who had not had a postinjection reaction. Severely impaired clearance also occurred in three out of four healthy people given 100 mg gold but they remained asymptomatic. The postinjection reaction may be an immune-complex disease that is triggered in certain patients because gold transiently inhibits reticuloendothelial function.