Abstract
Gold-induced interstitial pneumonia in a fourty-six years old female patient with rheumatoid arthritis was reported.
After she had recieved the last injection of gold sodium thiomalate (cumulative dose; 140mg), she complained non-productive cough and excertional dyspnea in addition to ulcerative stomatitis and generalized dermatitis. Diffuse reticular shadow on bilateral middle and lower lung fields was demonstrated by radiological examination. Pulmonary function revealed restrictive change, impaired diffusing capacity, and hypoxemia. Eosinophilia (7%) was detected, but serum IgE was within normal range. Both immediate and delayed type skin reactions against serially diluted gold salt were negative. Lymphocyte blastoid formation against gold salt increased significantly in the patient as compared with that in healthy person. Gold salt was discontinued and then the treatment with prednisolone (PSL; 30mg/day) was started. Improvement in the chest X-ray film and the pulmonary function test occurred eight months after the beginning of PSL.
Gold-induced interstitial pneumonia was highly suspected in this patient because of the mode of onset, the coexistence of stomatitis and dermatitis, and the excellent response to steroid therapy.
