Focal myopathy induced by chronic heroin injection is reversible.
We report a patient who developed a focal myopathy with prominent contractures of his thigh muscles induced by chronic heroin injection. Muscle biopsy and magnetic resonance imaging (MRI) were indicative of a fibrotic and inflammatory process. Treatment with steroids, D-penicillamine, and physical therapy led to full functional recovery within 6 months. Sequential electromyographic (EMG) studies and muscle biopsies showed evidence of regenerating muscle fibers and absence of inflammatory cells. We conclude that heroin-induced focal myopathy is reversible and that combination therapy with D-penicillamine and steroids may be useful.
Weber
M
M
Department of Neurology, University Hospital Essen, Essen, Germany. maus@interchange.ubc.ca
Diener
H C
HC
Voit
T
T
Neuen-Jacob
E
E
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D004576:Electromyography; D006177:Gynecomastia / Q000473:pathology; D006556:Heroin Dependence / Q000150:complications*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D018482:Muscle, Skeletal / Q000473:pathology; D009135:Muscular Diseases / Q000139:chemically induced* / Q000188:drug therapy / Q000473:pathology; D010396:Penicillamine / Q000627:therapeutic use; D013256:Steroids; D013848:Thigh / Q000473:pathology
D000893:Anti-Inflammatory Agents; D013256:Steroids; D010396:Penicillamine