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.
Kamijo
Yoshito
Y
Department of Emergency and Critical Care Medicine, Kitasato University, School of Medicine, Sagamihara Kanagawa, Japan.
Soma
Kazui
K
Nishida
Manami
M
Namera
Akira
A
Ohwada
Takashi
T
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