Sign Up for a Free Account
  • Updated 12.29.2023
  • Released 11.06.2001
  • Expires For CME 12.29.2026

Gold neurotoxicity



Historical note and terminology

Gold salt therapy (chrysotherapy) has been used in the treatment of rheumatoid arthritis for many years. Its use has declined in favor of methotrexate, chloroquine, and sulfasalazine (01). It shows efficacy as a second-line treatment in refractory pemphigus vulgaris (10). In its elemental form, it has been used for centuries as an antipruritic to relieve the itching palm (11). In the early part of the last century, Robert Koch used gold for the treatment of tuberculosis on the assumption that mycobacteria were the cause of rheumatoid arthritis. The most common gold preparations are aurothioglucose and sodium aurothiomalate; they contain 50% gold by weight, are water soluble, and are administered intramuscularly. Auranofin is the only available gold compound for oral use. Chrysotherapy is reported to decrease synovial inflammation and retard cartilage and bone destruction. Its mechanism of action may be based on effects on tumor necrosis factor-alpha (15). Neurotoxicity is uncommon, but includes encephalopathy, cranial neuropathy, myokymia, and peripheral neuropathy, including occasionally a Guillain-Barré-like clinical picture.

This is an article preview.
Start a Free Account
to access the full version.

  • Nearly 3,000 illustrations, including video clips of neurologic disorders.

  • Every article is reviewed by our esteemed Editorial Board for accuracy and currency.

  • Full spectrum of neurology in 1,200 comprehensive articles.

  • Listen to MedLink on the go with Audio versions of each article.

Questions or Comment?

MedLink®, LLC

3525 Del Mar Heights Rd, Ste 304
San Diego, CA 92130-2122

Toll Free (U.S. + Canada): 800-452-2400

US Number: +1-619-640-4660



ISSN: 2831-9125