ALVEOLAR-INTERSTITIAL PNEUMONOPATHY AFTER GOLD-SALTS COMPOUNDS ADMINISTRATION, REQUIRING MECHANICAL VENTILATION

The pulmonary toxicity of gold salts is an uncommon cause of life-thre atening respiratory failure. Currently, patients who suffer from this do not need mechanical ventilation, and the toxicity can be difficult to diagnose when it occurs in patient with an illness producing pulmon ary manifestations. We report a case of severe respiratory failure due to gold salt toxicity in a patient suffering from rheumatoid arthriti s requiring mechanical ventilation. At such a time, the poor respirato ry function makes some diagnostic procedures harmful. The diagnosis ca n be made after the exclusion of other causes of rheumatoid lung when the patient's poor respiratory status precludes invasive exploration. The clinical findings, radiological features, and results of pulmonary function tests map be enough to diagnose gold-related pneumopathy. Th is avoids the need for bronchoscopic examination or transfer of the pa tient for computed tomography. Attention must be paid to this complica tion because the outcome and functional prognosis are better when pulm onary involvement is gold related: in our case steroid therapy was lif e-saving and induced complete recovery of the lung damage.