THE CONTRIBUTION OF HIGH-RESOLUTION COMPU TER-TOMOGRAPHY IN THE DIAGNOSIS OF HYPERSENSITIVITY PNEUMONIA TO GOLD SALTS

A hypersensitivity pneumonia is rare during gold therapy. The underlyi ng mechanism is immunological in origine, of Gell and Coombs Type IV. As there are numerous possible pulmonary disorders during the course o f inflammatory rheumatism treated with gold, the early detection is vi tal, in order to prevent progress to fibrosis. In parallel with bronch o-alveolar lavage to look for a T8 lymphocytic alveolitis, which is ve ry suggestive, high resolution computed tomography has a place in the early diagnosis, to characterise the lesions, to aid in an aetiologica l diagnosis, and also to assess progress on treatment. The authors pre sent a case of pneumonitis induced by gold with visible interstitial l esions on computed tomography, accompanied by significant bronchial di storsion and bronchiectasis suggestive of fixed lesions. These lesions partially regressed following steroid therapy; the diagnostic and pro gnostic role for high resolution computer tomography was discussed.