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Successful treatment of intravenously abused oral Opana ER‐induced thrombotic microangiopathy without plasma exchange
Author(s) -
Miller Peter John,
Farland Andrew Matthew,
Knovich Mary Ann,
Batt Katharine Marie,
Owen John
Publication year - 2014
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.23720
Subject(s) - thrombotic microangiopathy , thrombotic thrombocytopenic purpura , therapeutic plasma exchange , medicine , gastroenterology , pediatrics , disease , platelet
In January 2013, the Centers for Disease Control and Prevention reported an illness associated with intravenous (IV) abuse of oral Opana ER (oxymorphone) in Tennessee. The clinical presentation of this syndrome was reported to resemble that of thrombotic thrombocytopenic purpura in the 15 patients reported; 12 were treated with plasma exchange. We report a similar case series of 15 patients with 18 episodes of thrombotic microangiopathy associated with recent IV abuse of oral Opana ER. In our series, we demonstrate that therapeutic plasma exchange is unnecessary; supportive care and treatment of underlying infections and renal dysfunction (without use of plasma exchange) resulted in clinical improvement in all patients. Thus, it appears that plasma exchange with associated costs and risks can be safely omitted in patients with thrombotic microangiopathy resulting from IV abuse of oral Opana ER. Am. J. Hematol. 89:695–697, 2014. © 2014 Wiley Periodicals, Inc.