Unusual complications of heroin abuse: transverse myelitis, rhabdomyolysis, compartment syndrome, and ARF.
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.
Sahni
Vaibhav
V
Department of Internal Medicine, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA. vaibhavsahni@hotmail.com
Garg
Dheeraj
D
Garg
Sandeep
S
Agarwal
Satish Kumar
SK
Singh
Narinder Pal
NP
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