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Autometallographic demonstration of gold in rheumatoid synovial tissue.

A new autometallographic method for the detection of gold was applied to synovial tissue obtained by synovectomy from 30 patients with chronic arthritis. Granules staining for gold were visualized in biopsies from 26 patients previously or currently treated with gold, but not in biopsies from untreated patients. Location of macrophages was confirmed, and in half the biopsies fibroblast-like cells were also stained. Lymphocytes, plasma cells and interstitial tissue were devoid of gold. Granules were seen after treatment with as small an amount as 85 mg gold sodium aurothiomalate. The amount of gold staining varied between the biopsies and seemed to be related to the amount of gold given. Within individual biopsies, the distribution of gold staining was irregular. It is suggested that there may be at least two targets of chrysotherapy in arthritic joints, and that an influence of gold on the immune system may take place, at least in part, via the macrophages. A relationship between the biopsy findings and the clinical course could not be established.