Ban Byung H, Verma Ashish, Tudor Maria, Sethi Jigme
Department of Internal Medicine, University of Tennessee Chattanooga, Chattanooga, TN 37403, USA.
Department of Pulmonary and Critical Care Medicine, University of Tennessee Chattanooga, Chattanooga, TN 37403, USA.
Oxf Med Case Reports. 2017 Jun 1;2017(6):omx026. doi: 10.1093/omcr/omx026. eCollection 2017 Jun.
Opana (oxymorphone) is a powerful semi-synthetic opioid agonist used for chronic pain management that is ingested orally. However, improper injection of Opana can lead to a rare and fatal blood disorder known as thrombotic microangiopathy. Opana-induced thrombotic microangiopathy can be easily mistaken for thrombotic thrombocytopenic purpura (TTP), leading to the initiation of therapeutic plasma exchange. Current literature has conflicting views on the necessity of therapeutic plasma exchange for the treatment of Opana-induced thrombotic microangiopathy. In our case report, a 47-year-old Caucasian male was admitted with a presentation suspicious for TTP then underwent therapeutic plasma exchange without clinical improvement. With supportive treatment only, the patient eventually improved and later admitted to intravenously abusing oral Opana 1-2 days prior to becoming ill.
奥帕纳（羟吗啡酮）是一种强效的半合成阿片类激动剂，用于口服治疗慢性疼痛。然而，不当注射奥帕纳会导致一种罕见且致命的血液疾病，即血栓性微血管病。奥帕纳诱发的血栓性微血管病很容易被误诊为血栓性血小板减少性紫癜（TTP），从而导致启动治疗性血浆置换。目前的文献对于治疗性血浆置换治疗奥帕纳诱发的血栓性微血管病的必要性存在相互矛盾的观点。在我们的病例报告中，一名47岁的白人男性因疑似TTP入院，随后接受了治疗性血浆置换，但临床症状并未改善。仅通过支持治疗，患者最终病情好转，后来承认在发病前1至2天静脉滥用口服奥帕纳。
