The Localization of Gold in the Human Kidney Following Chrysotherapy

Abstract

Using the histochemical method for the demonstration of gold in tissues, described by Gilg in 1952, 31 renal biopsies were examined from patients with rheumatoid arthritis. Renal tissues specimens from 10 of the patients, who had never been treated with gold, all showed negative results with this technique; the remaining 21 biopsies from 19 patients who had received sanocrysin therapy all showed positive results for gold. In all cases, irrespective of the interval from last sanocrysin injection to the time of biopsy, moderate occurrence of gold was found in the glomerular tuft. Deposits of gold were found in the proximal tubules, a short interval after the sanocrysin injection. Subsequently (1–4 years), the distal tubules seem to be a more characteristic localization. In the interstitial tissue gold is stored in macrophages in nearly all cases which have received more than a few injections; in this localization it can be demonstrated up to 28 years after the last injection of gold salts. The literature on the excretion of gold by the kidney is cited and discussed. This renal biopsy material has provided no information on the mechanism of the toxic effect of gold on the kidney. This effect is found as an occasional proteinuria following the administration of sanocrysin.