title: Unusual complications of heroin abuse: transverse myelitis, rhabdomyolysis, compartment syndrome, and ARF.
abstract: BACKGROUND
  Heroin overdose can cause various rare neurological complications like spongiform leukoencephalopathy, seizures, stroke, toxic amblyopia, transverse myelopathy, mononeuropathy, plexopathy, acute inflammatory demyelinating polyradiculoneuropathy, rhabdomyolysis, compartment syndrome, fibrosing myopathy, and acute bacterial myopathy. We report here the simultaneous presentation of multiple complications of heroin toxicity.
  
  
  METHODS
  A young heroin addict was found unarousable lying in the lotus posture. Examination showed quadriplegia and left leg gangrene. He subsequently developed heroin-induced transverse myelitis, rhabdomyolysis, left leg compartment syndrome, and myoglobin-induced acute renal failure.
  
  
  CONCLUSIONS
  This case leads us to consider a common linked or systemic mechanism of injury rather than a local mechanism when multiple simultaneous organ failure occurs complicating heroin abuse.
authors.affiliation: Department of Internal Medicine, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA. vaibhavsahni@hotmail.com
authors.forename: Vaibhav
authors.initials: V
authors.lastname: Sahni
authors.forename: Dheeraj
authors.initials: D
authors.lastname: Garg
authors.forename: Sandeep
authors.initials: S
authors.lastname: Garg
authors.forename: Satish Kumar
authors.initials: SK
authors.lastname: Agarwal
authors.forename: Narinder Pal
authors.initials: NP
authors.lastname: Singh
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology*; D000328:Adult; D003161:Compartment Syndromes / Q000209:etiology*; D005734:Gangrene / Q000209:etiology; D006556:Heroin Dependence / Q000150:complications*; D006801:Humans; D008297:Male; D009188:Myelitis, Transverse / Q000209:etiology*; D011782:Quadriplegia / Q000209:etiology; D012206:Rhabdomyolysis / Q000209:etiology*; D014474:Unconsciousness / Q000209:etiology