Significance of eosinophilia during gold therapy

Abstract

Abstract Adverse clinical reactions (predominantly skin rashes) were seen in 14 of 50 patients receiving gold therapy for rheumatoid arthritis. In 11 of the 14 eosinophilia either accompanied or preceded the reaction. A further 9 patients who received gold developed eosinophilia alone. IgE levels were increased in 17 of the 20 patients with eosinophilia but were normal in 24 of 27 patients who received gold without apparent adverse effects. In only 1 patient on gold was a skin rash not accompanied by either eosinophilia or a raised IgE level. All eosinophil counts and IgE levels fell to normal after therapy was discontinued. It is suggested that eosinophilia may be the most common side effect of gold therapy and provides a useful guide for monitoring patients receiving gold salts. The strong association with raised IgE levels suggests that type 1 hypersensitivity may be the mechanism of these reactions.