Morphological findings in fatal drug addiction. An investigation of injection marks, endocrine organs and kidneys.

Tissue sections from injection marks from 30 drug addicts and sections from endocrine organs and kidneys from an additional 33 addicts were studied together with endocrine organs and kidneys from 20 'normal' persons. All 83 persons were submitted for medico-legal autopsy at the Institute of Forensic Medicine in Copenhagen. In fresh injection marks haemorrhage in dermis and subcutis was present histologically in all cases. Acute inflammation was present in 38% and acute inflammation together with chronic changes in 41%. Fibrotic thickening of vein wall was seen in 14% and thrombosis in 10%. Birefringent foreign material occurred in 35%. In old injection marks and scars chronic inflammatory changes were observed in 93%, fibrotic thickening of vein wall in 20% and thrombosis in 10% of the cases. Birefringent material occurred in 17%. By comparison of changes in injection marks with the size and histological changes in the corresponding axillary lymph nodes, there was a tendency to a relation between chronic inflammatory changes in old injection marks/scars and enlargement of the lymph nodes in question, but no correlation to the histological degree of immunoactivity. Regarding alterations in the endocrine organs and the kidneys no important differences were demonstrated between drug addicts and 'normal' persons.