Acute liver failure following intravenous methamphetamine.
A 41-y-o Pakistani man presented with psychosis, hyperthermia, rhabdomyolysis, and liver dysfunction approximately 6 h after i.v. injection of methamphetamine. Serum concentrations of methamphetamine and amphetamine on admission were 0.30 microg/mL and 0.04 microg/mL, respectively. Total serum bilirubin and alanine aminotransferase concentrations peaked on the 3rd hospital day at 8.6 mg/dL and 4155 IU/L, respectively, and gradually returned to normal with supportive care. The patient had no evidence of infectious hepatitis or intake of other drugs. Histologic examination of a liver biopsy specimen obtained on the 11th d showed confluent necrosis and ballooning degeneration in centrilobular zones. No inflammatory changes were seen in portal tracts. Liver damage can be a complication of illicit methamphetamine use, even in patients without viral infection or intake of other drugs.
Department of Emergency and Critical Care Medicine, Kitasato University, School of Medicine, Sagamihara Kanagawa, Japan.
Yoshito
Y
Kamijo
Kazui
K
Soma
Manami
M
Nishida
Akira
A
Namera
Takashi
T
Ohwada
D000328:Adult; D001706:Biopsy; D000697:Central Nervous System Stimulants / Q000008:administration & dosage / Q000009:adverse effects*; D005334:Fever / Q000139:chemically induced; D006801:Humans; D017114:Liver Failure, Acute / Q000139:chemically induced* / Q000473:pathology; D008297:Male; D008694:Methamphetamine / Q000008:administration & dosage / Q000009:adverse effects*; D009336:Necrosis; D012206:Rhabdomyolysis / Q000139:chemically induced
D000697:Central Nervous System Stimulants; D008694:Methamphetamine