慢性関節リウマチ患者における金療法による腎障害の臨床的検討

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  • Clinical study of renal injury by gold therapy in patients with rheumatoid arthritis

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Clinicopathological studies were done in 7 patients with rheumatoid arthritis who developed proteinuria and/or hematuria while receiving gold salts. Hematuria was found as the major abnormal finding in 5 out of 7 patients. After discontinuation of gold therapy, proteinuria and/or hematuria had been improved or disappeared. The decreased renal function test such as less than the value of 50ml/min in creatinine clearance was, however, observed in 4 out of 7 patients. The improvement of renal function in 2 patients was not obtained even after avoidance of gold injection. The clinical outcome of one of the patients became worse and uremic.<br>Light microscopic study of renal biopsy specimens revealed various glomerular lesions (minor glomerular abnormality 2, focal and segmental lesions 1, mesangial proliferative glomerulonephritis 2, membranous glomerulonephritis 1, sclerosing glomerulonephritis 1) and tubulointerstitial change were observed in 3 cases. Using X ray energy dispersive analysis, gold depositions were found within proximal tubular epitherial cells in all cases.

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