Correlation of the erythrocyte sedimentation rate and gold complications in rheumatoid arthritis.

Certain observations have been reported according to which complications in association with gold therapy in rheumatoid arthritis would seem to be inversely proportional to the erythrocyte sedimentation rate (Goldie, 1939; Ellman and others, 1940; Lawrence, 1953). This has been explained on the basis that a high E.S.R. is generally seen in the active exudative stage of the disease, and that the gold, which has become bound to the globulins, is then able to penetrate through the damaged capillaries into the diseased tissue. Consequently the gold concentration in the skin, bone marrow, and other tissues is unable to attain the same levels as when the E.S.R. is low and the disease is in a less active stage. Since this point is an important one in clinical practice, I have observed the possible correlation of gold complications and E.S.R. in patients receiving continuous gold therapy at the Turku Polyclinic for Rheumatic Diseases.