Thakur Kamia, Agrawal Vaibhav, Kass Ashley, Dimarino Lauren M, Dorion R Patrick, Vadakara Joseph
Geisinger Medical Center, Danville, PA, USA.
Case Rep Hematol. 2017;2017:1623907. doi: 10.1155/2017/1623907. Epub 2017 May 18.
Opana ER (oxymorphone) is an opioid drug available throughout the United States, and intravenous abuse of the crushed oral formulation has been associated with drug-induced thrombotic microangiopathy. In this abstract, we describe two young patients who lived together and used Opana ER intravenously. Both presented with microangiopathic hemolytic anemia that mimicked thrombotic thrombocytopenic purpura (TTP). Treating this condition poses a clinical challenge, as it is difficult to distinguish it from TTP. The role for plasma exchange is not clear but can be used while awaiting the results of the ADAMTS-13 activity, but ultimately supportive care with drug discontinuation is the recommended therapy of choice. Patients should be counseled against Opana ER's intravenous use, and users should be offered drug rehabilitation therapy.
奥施康定缓释片（羟吗啡酮）是一种在美国各地均可获得的阿片类药物，碾碎口服制剂后进行静脉注射滥用与药物性血栓性微血管病有关。在本摘要中，我们描述了两名住在一起并静脉注射奥施康定缓释片的年轻患者。两人均出现了类似血栓性血小板减少性紫癜（TTP）的微血管病性溶血性贫血。治疗这种疾病带来了临床挑战，因为很难将其与TTP区分开来。血浆置换的作用尚不清楚，但可在等待ADAMTS-13活性结果时使用，但最终推荐的治疗选择是停药后的支持性治疗。应告诫患者不要静脉注射奥施康定缓释片，并应为使用者提供药物康复治疗。
