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Successful treatment of intravenously abused oral Opana ER-induced thrombotic microangiopathy without plasma exchange.
Am J Hematol. 2014 Jul; 89(7):695-7.AJ

Abstract

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.

Authors+Show Affiliations

Department of Medicine, Section on Hematology and Oncology, Wake Forest School of Medicine, Winston-Salem, North Carolina.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

24668845

Citation

Miller, Peter John, et al. "Successful Treatment of Intravenously Abused Oral Opana ER-induced Thrombotic Microangiopathy Without Plasma Exchange." American Journal of Hematology, vol. 89, no. 7, 2014, pp. 695-7.
Miller PJ, Farland AM, Knovich MA, et al. Successful treatment of intravenously abused oral Opana ER-induced thrombotic microangiopathy without plasma exchange. Am J Hematol. 2014;89(7):695-7.
Miller, P. J., Farland, A. M., Knovich, M. A., Batt, K. M., & Owen, J. (2014). Successful treatment of intravenously abused oral Opana ER-induced thrombotic microangiopathy without plasma exchange. American Journal of Hematology, 89(7), 695-7. https://doi.org/10.1002/ajh.23720
Miller PJ, et al. Successful Treatment of Intravenously Abused Oral Opana ER-induced Thrombotic Microangiopathy Without Plasma Exchange. Am J Hematol. 2014;89(7):695-7. PubMed PMID: 24668845.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Successful treatment of intravenously abused oral Opana ER-induced thrombotic microangiopathy without plasma exchange. AU - Miller,Peter John, AU - Farland,Andrew Matthew, AU - Knovich,Mary Ann, AU - Batt,Katharine Marie, AU - Owen,John, Y1 - 2014/04/15/ PY - 2014/02/21/received PY - 2014/03/17/revised PY - 2014/03/21/accepted PY - 2014/3/27/entrez PY - 2014/3/29/pubmed PY - 2014/10/10/medline SP - 695 EP - 7 JF - American journal of hematology JO - Am. J. Hematol. VL - 89 IS - 7 N2 - 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. SN - 1096-8652 UR - https://www.unboundmedicine.com/medline/citation/24668845/Successful_treatment_of_intravenously_abused_oral_Opana_ER_induced_thrombotic_microangiopathy_without_plasma_exchange_ L2 - https://doi.org/10.1002/ajh.23720 DB - PRIME DP - Unbound Medicine ER -