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Light and electron microscopic studies were performed on renal biopsies of three patients who developed proteinuria following injections of gold in the treatment of rheumatoid arthritis. The renal lesions were shown to be lipoid nephrosis in one patient and membranous glomerulonephritis in two patients. One of the three cases developed a typical nephrotic syndrome. In the cases presented, gold was felt to be the antigenic stimulus promoting the development of the renal lesion.Studios de microscopia optic e electronic esseva executate in biopsias renal de tres patientes qui disveloppava proteinuria post injectiones de auro in le tractamento de arthritis rheumatoide. Esseva constatate que le lesiones renal esseva nephrosis lipoide in un caso e glomerulonephritis membranose in le duo alteres. Un del tres patientes disveloppava un typic syndrome nephrotic. In le casos presentate il esseva opinate que auro esseva le agente del stimulo antigenic que promoveva le disveloppamento del lesion renal, HE NEPHROTIC SYNDROME as a complication of drug therapy has T been reported following the administration of a number of chemical agents including probenecid,l paramethadione,2 trimethadione,3-? tolbutamide,s perchlorateg and penkillaminel0 etc. Several papers have noted the association of the nephrotic syndrome with compounds containing heavy metals, particularly mercury,11-14 although b i s m~t h~~~~~ and gold salt^^'-^^ have also been incriminated. Numerous reports of gold therapy followed by renal lesions are also found in the European literature. Many of these are mentioned by Gregoire et. al.,25 Rathenz et. a1.26 and by Derot et. al.27 Published photomicrographs have shown thickening of the glomerular basement membrane. However, both gold2? and mercuryz8 can produce acute tubular necrosis accompanied by renal failure.This report describes renal lesions in three patients following injections of gold sodium thiomalate and gold sodium thiosulfate for rheumatoid arthritis. Light and electron microscopic studies of rend biopsy material from

Vascular and neurologic manifestations were observed in nine patients with advanced (stages I11 or IV) rheumatoid arthritis having subcutaneous nodules and large amounts of rheumatoid factor. The possible role of corticosteroid therapy in the pathogenesis of the neurovascular lesions is discussed.Manifestationes vascular e neurologic esseva observate in 9 patientes con arthritis rheumatoide avantiate (stadios 111 e IV), le quales habeva nodulos subcutanee e grande quantitates de factor rheumatoide. Le rolo possibile de therapia corticosteroide in le pathogenese del lesiones neurovascular es discutite.

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