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Aplastic Anemia Secondary to Gold-Salt Therapy:  Report of Fatal Case and a Review of Literature

Daniel J. McCarty, M.D.; Joseph M. Brill, M.D.; Donald Harrop, M.D.
JAMA. 1962;179(8):655-657. doi:10.1001/jama.1962.03050080067017a.
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RECENTLY WE ADMINISTERED gold salts to a patient with rheumatoid arthritis who subsequently died from aplastic anemia during treatment. As only 20 well-documented cases of aplastic or "hypoplastic," anemia secondary to gold therapy have been recorded in 30 years, and since none has been reported in the past decade, it seemed worth while to add this case.

Gold salts have been frequently employed in the treatment of rheumatoid arthritis since Forestier 's report in 1929, and their use has produced severe toxic effects in about 4.5% of cases. These effects include pruritus, dermatitis, stomatitis, nephritis, hepatitis, and bone marrow depression. Judging by the frequency of reported cases, one may infer that platelet production is most often affected; increasing toxicity may impair leukocytic formation also, while the severest toxicity may result in aplasia of all 3 marrow elements. The previously reported cases of aplastic anemia coinciding with gold-salt therapy have been

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