Reinstitution of gold after gold induced proteinuria.

Abstract

To assess the benefits and risks to patients who resumed gold after discontinuation of gold because of proteinuria. We conducted a review of records of all patients who had resumed gold after discontinuing treatment because of proteinuria. Eight patients developed proteinuria > or = 500 mg/dl while receiving 50 mg weekly doses in the first year of treatment. Proteinuria took a minimum of 4 mo to resolve. No patient had a recurrence of proteinuria when gold was resumed at a lower dosage of 25 mg every 1-2 weeks. This strategy has been successful in 5/8 patients who continue taking gold and are markedly improved compared to pretreatment status after 3-7 years (mean 5 years) of followup. The risk of gold induced proteinuria may be dose related and reinstitution of gold at a lower dose is safe in our experience and effective in selected patients.