X-ray microanalysis of crystalline material in the liver of a narcotics user.
A 22-year-old athlete, who had had intravenous injections of narcotics in the past, developed a viral hepatitis with markedly altered liver enzyme values. Studies revealed evidence of a virtual cure of hepatitis B virus and a current infection with delta agent. Liver biopsy showed a mixed-cell portal inflammation and doubly refractile crystalline particles. These particles were shown by energy-dispersive x-ray microanalysis to contain calcite, silica, talc, and a variety of elements including Al, P, S, Cl, K, Ti, Cr, Fe, Ni, Br, Yb, Os, Ir, and a trace U. The predominance of Ca-containing compounds suggested that the foreign material was present as a result of the chemical preparation of the narcotic or as a narcotic diluent. The potential for pathologic alteration by the various substances is discussed. These observations support the idea of particulate-induced hepatic disease advanced previously by others.
D000328:Adult; D003460:Crystallization; D004577:Electron Probe Microanalysis; D006801:Humans; D007275:Injections, Intravenous / Q000009:adverse effects*; D008099:Liver / Q000032:analysis / Q000648:ultrastructure*; D008297:Male; D009293:Opioid-Related Disorders / Q000150:complications* / Q000473:pathology