Neurologic complications induced by gold treatment

Abstract

Two patients developed a Guillaiq-Barre-like syndrome and a third suffered neuropathy and myokymia during therapy with sodium aurothiomalate. The cumulative dose at the time of development of neuropathy was different in all 3 cases. Evidence for gold toxicity was suggested by clinical, electromyographic, and histologic findings, as well as the disappearance of symptoms and signs on cessation of gold iqjjections.Gold neuropathy is a rare complication of gold therapy in rheumatoid arthritis (RA). This side effect has received little attention in textbooks of pharmacology and toxicology or in rheumatology (1-12). Even in recent publications on drug-induced neuropathies or in reviews of undesirable effects of gold, this side effect is hardly mentioned ( 1 3-20). Interestingly, the majority of the available case reports on this complication are found in journals of ). An early survey of the cases reported by French physicians was given by Lescher in 1936 (38 CASE REPORT Patient 1A 67-year-old man developed polyarthritis in autumn of 1977. This patient showed marked morning stiffness and symmetric joint swelling, including midphalangeal and mctacarpophalangeal joints. New joint involvement in all extremities progressed over the next 2 months. No typical extraarticular findings of rheumatoid disease could be detected. Latex fixation test (Singer-Plotz method) and sheep cell agglutination test (SCAT, Waaler-Rose) were both positive from the beginning of the arthritis. Gold treatment was started in November 1977, 2 months after the diagnosis was established.In May 1978 he was admitted with generalized weakness and speech difficulty. At the time of admission, a total amount of 1.6 gm gold (sodium aurothio-

INSIdE NANO: a systems biology framework to contextualize the mechanism-of-action of engineered nanomaterials

“…Moreover, exposure to Au NP decreased the levels of the neurotransmitters dopamine and serotonin. It is pertinent to note that gold is widely used for the treatment of rheumatoid arthritis (RA) and that neurotoxicity has been documented in patients with RA receiving oral or injectable gold 28,29 . Whether or not Au NP also elicit similar effects is unknown.…”

Mechanistic Insights into the Biological Effects of Engineered Nanomaterials: A Focus on Gold Nanoparticles

“…It is well known that AuNPs may induce oxidative stress in vitro and in vivo in brain cells and, in some cases, a concomitant antioxidant response is not observed, increasing the chances of cell damage and diseases. Moreover, neurotoxicity has been reported in patients with rheumatoid arthritis (RA) who received gold treatment [ 70 , 71 ]. However, it is still being determined whether gold in the nanoscale may elicit similar effects.…”

Toxic Neuropathies

“…Case reports of neuropathy with myokymia and a Guillain-Barré-like syndrome in patients treated with gold for rheumatoid arthritis have been described. 40…”