adverse reactions of gold sodium thiomalate in rheumatoid arthri tis patients in southern iran

to confirm the side-effects of gold sodium thiomalate (gstm), we carried out a retrospective study examining 102 consecutive patients with rheumatoid arthritis attending the rheumatology unit of hafez hospital, shiraz, iran, in whom gstm was initiated between 1983-1989. only patients with classical or definite ra (ara criteria) we(e included in this study. patients were categorized as having developed toxicity to gold if rash, stomatitis, leukopenia «4000/mm3), thrombocytopenia «ioo,000/mm3), anemia (hb<10gm/dl), microscopic hematuria (more than 5 rbc in each hpf) and proteinuria (1 +or more) appeared during chrysotherapy. sixty-six (64.7%) patients developed adverse reactions. more significant side-effects were pruritus (57.8%), eosinophilia (23.5%), microscopic hematuria (20.5%), and low hb (20.5%). inadequate primary response and relapses on therapy accounted for termination in 15.6% of patients, nephrotic syndrome in 0.9%, hepatitis in 1.9%, colitis in 2.9%, persistent pruritus in 1.9%, extensive lichenoid rash in 3.9%, persistent stomal ulcer in 0.9% and persistent hematuria in 1.9% of patients. lichenoid rash was more significant and more extensive in our series compared to others.