Successful lung transplantation for talcosis secondary to intravenous abuse of oral drug.
Talcosis due to intravenous injection of oral drugs can cause severe pulmonary disease with progressive dyspnea even when drug use is discontinued. We describe a 54-year-old woman with severe emphysema who underwent left lung transplantation. The patient had a remote history of intravenous injection of crushed methylphenidate (Ritalin) tablets. Chest computed tomography showed severe emphysematous changes, more prominent in the lower lobes. Microscopic examination of the extracted lung demonstrated multinucleated giant cells with birefringent crystals, compatible with talcosis. At follow-up, daily symptoms were completely alleviated and lung function was good. We recommend that lung transplantation be considered as a viable option in the treatment of talcosis.
Shlomi
Dekel
D
Pulmonary Institute, Department of Cardiothoracic Surgery, Rabin Medical Center, Beilinson Campus, Petah Tiqva, Israel.
Shitrit
David
D
Bendayan
Daniele
D
Sahar
Gidon
G
Shechtman
Yitshak
Y
Kramer
Mordechai R
MR
D000697:Central Nervous System Stimulants / Q000008:administration & dosage* / Q000009:adverse effects; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007275:Injections, Intravenous; D008171:Lung Diseases / Q000139:chemically induced / Q000175:diagnosis / Q000601:surgery*; D016040:Lung Transplantation / Q000379:methods*; D008774:Methylphenidate / Q000008:administration & dosage* / Q000009:adverse effects; D008875:Middle Aged; D015819:Substance Abuse, Intravenous / Q000150:complications*; D013607:Tablets; D013627:Talc / Q000008:administration & dosage / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed
D000697:Central Nervous System Stimulants; D013607:Tablets; D013627:Talc; D008774:Methylphenidate