Light- and electron-microscopical study of a case of gold salt—induced hepatotoxicity

Authors

  • Gerald M. Fleischner,

    1. Department of Medicine, Albert Einstein College of Medicine, Bronx
    2. Jack D. Weiler Hospital—Montefiore Medical Center, Bronx, New York 10461
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  • Rachel Morecki,

    1. Department of Pathology, Albert Einstein College of Medicine, Bronx
    2. Jack D. Weiler Hospital—Montefiore Medical Center, Bronx, New York 10461
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  • Takamasa Hanaichi,

    1. Electron Microscope Center, Nagoya University School of Medicine, Showa-Ku, Nagoya 466, Japan
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  • Hisao Hayashi,

    1. Electron Microscope Center, Nagoya University School of Medicine, Showa-Ku, Nagoya 466, Japan
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  • Nelson Quintana,

    1. Department of Pathology, Albert Einstein College of Medicine, Bronx
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  • Irmin Sternlieb M.D.

    Corresponding author
    1. Department of Medicine, Albert Einstein College of Medicine, Bronx
    2. Department of Liver Research Center, Albert Einstein College of Medicine, Bronx
    3. Jack D. Weiler Hospital—Montefiore Medical Center, Bronx, New York 10461
    • Liver Research Center, Albert Einstein College of Medicine, U-517, 1300 Morris Park Avenue, Bronx, NY 10461
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Abstract

A 56-yr-old woman with long-standing rheumatoid arthritis exhibited jaundice, pruritus and abdominal discomfort after 8 yr of periodic gold sodium thiomalate injections amounting to a cumulative dose in excess of 2.5 gm. Histopathological examination of the liver biopsy specimen showed submassive loss of parenchyma, collapse of reticulin and mixed cellular inflammatory infiltrates. Macrophages contained dark granules, which displayed the characteristics of aurosomes when examined by transmission electron microscopy and electron microprobe analysis. It is likely that hepatocellular injury occurred when the lysosomal storage capacity for gold was exceeded.

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