To investigate the possible association between HLA antigens and adverse reactions to gold sodium thiomalate therapy (GSTM).
Ninety consecutive patients with rheumatoid arthritis (RA) were studied for possible association between HLA antigens and adverse reactions to GSTM therapy.
HLA-DR5 was significantly increased in patients who developed gold induced mucocutaneous lesions. On the other hand, patients with RA carrying B8 and DR3 antigens are of a high risk of developing proteinuria after gold therapy. A very interesting finding was the low incidence of DR7 antigen in patients who developed adverse reactions to GSTM. We also report the relationship between B27 antigen and chrysiasis due to gold therapy.
Our results support suggestions that the DR7 antigen provides a protective effect against gold toxicity. We also found a strong association between DR5 and mucocutaneous lesions in patients with RA treated with GSTM.