出典(authority):フリー百科事典『ウィキペディア(Wikipedia)』「2014/10/31 20:08:53」(JST)
Gold salts are ionic chemical compounds of gold. The term, which is a misnomer, has evolved into a synonym for the gold compounds used in medicine. The application of gold compounds to medicine is called "chrysotherapy" and "aurotherapy."[1] The first reports of research in this area appeared in 1935,[2] primarily to reduce inflammation and to slow disease progression in patients with rheumatoid arthritis. The use of gold compounds decreased since the 1990s because of numerous side effects and monitoring requirements, limited efficacy, and very slow onset of action. Most chemical compounds of gold, including some of the drugs discussed below, are not, in fact, salts but are examples of metal thiolate complexes.
Investigation of medical applications of gold salts began at the end of the 19th century, when gold cyanide demonstrated effectiveness against Mycobacterium tuberculosis.[3]
The use of injected gold salts is indicated for rheumatoid arthritis. However, the use of gold is now rare due to numerous side effects, the need for continual patient monitoring, limited efficacy and slow onset of action. The efficacy of orally administered gold is even more limited than injectable gold compounds.[4]
The mechanism by which gold drugs affect arthritis is unknown.[4]
Gold salts for rheumatoid arthritis are administered by intramuscular injection but can also be administered orally (although the efficacy is low). Regular urine tests to check for protein (indicating kidney damage) and blood tests are needed.
A 1997 review (Suarez-Almazor ME et al.)[5] reports that treatment with intramuscular gold (parenteral gold) reduces disease activity and joint inflammation. Gold salts taken by mouth are less effective than by injection. Three to six months are often required before gold treatment noticeably improves symptoms.
One noticeable side-effect of gold-based therapy is the coloring of the skin in shades of mauve to a purplish dark grey when exposed to sunlight, if the salts are taken on a regular basis over a long period of time .[6] Excessive intake of gold salts while undergoing chrysotherapy result – through complex redox processes – in the saturation by relatively stable gold compounds of skin tissue and organs (as well as teeth and ocular tissue in extreme cases), a condition known as chrysiasis, similar to a certain extent to argyria which is related to silver salts and colloidal silver. Chrysiasis can ultimately lead to acute renal failure (such as tubular necrosis, nephrosis, glomerulitis ),[7] severe heart conditions and hematologic complications (leukopenia, anemia).[8][9][10] While some effects can be healed with moderate success, the pigmentation of the skin is considered permanent.
Other side effects of gold salts include kidney damage, itching rash, and ulcerations of the mouth, tongue and pharynx. Approximately 35% of patients discontinue the use of gold salts because of these side effects. Kidney function must be monitored continuously while taking gold salts.[4]
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