Two fatal cases of aplastic anemia which developed after administration of gold salt for the treatment of rheumatoid arthritis were reported. The frst case was a 58-year-old female who had received aurothioglucose 390 mg totally during the period of 5 months. On admission, serere pancytopenia (platelet 7000/mm3, leucocyte count 900/mm3 with 1% nuetrophil) was noted. No recovery was obtained in spite of anabolic steroid therapy and she expired on the 15th hospital day from septicemia and intracranial bleeding. The second case was a 43-year-old housewife who had received sodium aurothiomalate 600mg totally during the period of 8 months. And then bleeding tendency developed. She had marked pancytopenia (Hb 5.0g/dl, leucocyte count 1200/mm3 with 6% neutrophil, platelet 8000/mm3) and severe hypoplastic bone marrow. Any treatment, including BAL, lithium, and anabolic steroid, failed to improve bone marrow findings. She died four months later due to septicemia and subarachnoidal hemorrhage.
As far as we reviewed the recent literatures, 14 cases of aplastic anemia induced by gold salt therapy have been reported. The mortality rate was high (64.3%).
