In a double-blind study, patients were randomly selected for treatment using conventional doses (CD; 50 mg) or high doses (HD; 150 mg) of sodium aurothiomalate given weekly by injection. Twenty-three patients were assigned to the CD group and 24 to the HD group. Neither efficacy nor toxicity correlated with serum gold concentrations. Conventional doses were as efficacious as high doses with respect to both rapidity and degree of response. However, side effects were much more frequent and severe in the HD group. Thus there is no reason to recommend a 150 mg weekly dosage regimen.The use of gold salts in the treatment of rheumatoid arthritis (RA) has been proved-effective by many years of clinical experience and by a number of controlled studies (1-8). However, the most effective and least toxic dosage schedule for administration of gold has not been firmly established. Perhaps because 50 mg of gold compound were used in the Empire Rheumatism

No abstract

A 25-year-old woman had systemic lupus erythematosus manifested primarily by severe cutaneous vasculitis that was unresponsive to oral prednisone and azathioprine. She was treated with thoracic duct drainage (TDD). Her course was followed by serial photographs, skin biopsies, and serum immunoglobulin, antinuclear antibody, and complement levels. After 1 week of drainage there was obvious clinical improvement. During the remainder of her drainage, the vasculitis continued to improve. It was possible to taper oral corticosteroids and to discontinue azathioprine during TDD without any clinical or laboratory evidence of exacerbation. The patient had no recurrence of vasculitis 22 weeks after the termination of TDD.We report a patient with systemic lupus erythematosus (SLE) with severe cutaneous vasculitis who was treated with prolonged thoracic duct drainage. To our knowledge this is the first reported case of SLE with cutaneous vasculitis successfully treated with thoFrom the