To the Editor.
—In a report of six cases of gold-associated thrombocytopenia, Deren et al1 stated that the effects of gold lasted only a few months in the majority of patients, but that they were unable to demonstrate an immunologic basis for the thrombocytopenia. They concluded that the disease is self limited and that low-steroid therapy is the treatment of choice, and they advised against splenectomy, except in cases of severe steroid toxic reactions.1 We have also been unable to provide evidence to support the theory of an immunologic mechanism2 for the thrombocytopenia. However, in contrast to the observations by Deren et al,1 we have found prolonged thrombocytopenia after gold therapy in two patients.
Patient Summaries.—Patient 1.
—A 52-year-old woman was first noted to have thrombocytopenia (platelet count, 30,000/cu mm) in September 1971 following therapy with aurothioglucose (total dose, 650 mg). Her serum gold