Department of Pediatrics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland.
Department of Child Health, District Hospital in Rydułtowy, Rydułtowy, Poland.
BMC Psychiatry. 2022 Jul 28;22(1):509. doi: 10.1186/s12888-022-04135-3.
Youth drug addiction is a significant social and health problem. Symptoms of the disease include a number of neurological, gastrointestinal and cardiovascular disorders. Possible hormonal disorders and dysregulation of the immune system could also occur.
We describe a case of a teenage patient with multiple diseases such as esophagitis, allergic disease, and numerous behavioral disorders leading to: self-injury of the body, suicide attempts by drugs overdosing, and experimentation with various psychoactive substances (morphine, amphetamine, methamphetamine, codeine). She was also diagnosed with bipolar disorder. A few hours before the admission to the ward, the patient had an intravenous injection of drugs. Toxicological tests confirmed the presence of amphetamine, ecstasy and opioids in the blood and urine. Laboratory tests revealed extremely increased inflammatory parameters, leucopenia, increased levels of IgG, IgA and IgE (total) immunoglobulins, low concentration of vitamin D. Bacteriological examinations were negative. General condition of the patient got better very quickly, antibiotic therapy was abandoned on the 4 day. It was concluded that the cause of the elevated concentration of acute-phase proteins was most likely caused by intoxication with psychoactive drugs.
The discussed case shows the difficulties of differential diagnosis in a teenage patient struggling with many diseases, who has been abusing drugs for several years. Increased inflammatory parameters in the form of an raised PCT, CRP, NLR, PLR values may be caused by many factors. In adolescents who frequently experiment with psychoactive substances, such cause of these disturbances should also be taken into account.
青少年吸毒是一个严重的社会和健康问题。该疾病的症状包括许多神经、胃肠道和心血管紊乱。也可能发生荷尔蒙紊乱和免疫系统失调。
我们描述了一位青少年患者的病例，该患者患有多种疾病，如食管炎、过敏疾病和许多行为障碍，导致：自残、药物过量自杀企图以及尝试各种精神活性物质（吗啡、安非他命、冰毒、可待因）。她还被诊断为双相情感障碍。在被送入病房前几个小时，患者静脉注射了药物。毒理学测试证实血液和尿液中存在安非他命、摇头丸和阿片类物质。实验室检查显示炎症参数极高、白细胞减少、IgG、IgA 和 IgE（总）免疫球蛋白水平升高、维生素 D 浓度降低。细菌学检查结果为阴性。患者的一般状况很快好转，第 4 天停止使用抗生素。结论是，急性期蛋白浓度升高的原因很可能是由于精神活性药物中毒。
所讨论的病例表明，在一个患有多种疾病且多年吸毒的青少年患者中，鉴别诊断存在困难。以 PCT、CRP、NLR、PLR 值升高的形式出现的炎症参数升高可能由多种因素引起。在经常尝试精神活性物质的青少年中，也应考虑到这些紊乱的原因。
