Kendrick W C, Hull A R, Knochel J P
Ann Intern Med. 1977 Apr;86(4):381-7. doi: 10.7326/0003-4819-86-4-381.
Five patients who had injected intravenous (i.v.) phenmetrazine or methamphetamine developed marked prostration resembling septic shock, disseminated intravascular coagulation, rhabdomyolysis with myoglobinuria, and azotemia. Soon after injection, four noted chills, fever, sweats, nausea, and abdominal cramps. Within hours, they developed vomiting, myalgias, paresthesias, headache, and orthostasis. Cardiorespiratory arrest, accelerated bleeding, and noncardiac pulmonary edema were observed in one patient. From 4 to 11 litres of saline were required in the first 24 h to maintain blood pressure and urine output, suggesting that shock resulted from massive loss of intravascular volume into necrotic muscle. Recognition of this syndrome and treatment by aggressive volume replacement led to the recovery of all five patients.
五名静脉注射苯丙胺或甲基苯丙胺的患者出现了类似感染性休克的明显虚脱、弥散性血管内凝血、伴有肌红蛋白尿的横纹肌溶解以及氮质血症。注射后不久，四名患者出现寒战、发热、出汗、恶心和腹部绞痛。数小时内，他们出现呕吐、肌痛、感觉异常、头痛和直立性低血压。一名患者出现心肺骤停、出血加速和非心源性肺水肿。在最初24小时内需要4至11升生理盐水来维持血压和尿量，这表明休克是由于血管内液体大量渗入坏死肌肉所致。认识到这种综合征并通过积极的容量替代进行治疗，使得所有五名患者均康复。
