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Opana-induced thrombotic microangiopathy masquerading as thrombotic thrombocytopenic purpura.
Oxf Med Case Reports. 2017 Jun; 2017(6):omx026.OM

Abstract

Opana (oxymorphone) is a powerful semi-synthetic opioid agonist used for chronic pain management that is ingested orally. However, improper injection of Opana can lead to a rare and fatal blood disorder known as thrombotic microangiopathy. Opana-induced thrombotic microangiopathy can be easily mistaken for thrombotic thrombocytopenic purpura (TTP), leading to the initiation of therapeutic plasma exchange. Current literature has conflicting views on the necessity of therapeutic plasma exchange for the treatment of Opana-induced thrombotic microangiopathy. In our case report, a 47-year-old Caucasian male was admitted with a presentation suspicious for TTP then underwent therapeutic plasma exchange without clinical improvement. With supportive treatment only, the patient eventually improved and later admitted to intravenously abusing oral Opana 1-2 days prior to becoming ill.

Authors+Show Affiliations

Department of Internal Medicine, University of Tennessee Chattanooga, Chattanooga, TN 37403, USA.Department of Internal Medicine, University of Tennessee Chattanooga, Chattanooga, TN 37403, USA.Department of Internal Medicine, University of Tennessee Chattanooga, Chattanooga, TN 37403, USA.Department of Pulmonary and Critical Care Medicine, University of Tennessee Chattanooga, Chattanooga, TN 37403, USA.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

28580158

Citation

Ban, Byung H., et al. "Opana-induced Thrombotic Microangiopathy Masquerading as Thrombotic Thrombocytopenic Purpura." Oxford Medical Case Reports, vol. 2017, no. 6, 2017, pp. omx026.
Ban BH, Verma A, Tudor M, et al. Opana-induced thrombotic microangiopathy masquerading as thrombotic thrombocytopenic purpura. Oxf Med Case Reports. 2017;2017(6):omx026.
Ban, B. H., Verma, A., Tudor, M., & Sethi, J. (2017). Opana-induced thrombotic microangiopathy masquerading as thrombotic thrombocytopenic purpura. Oxford Medical Case Reports, 2017(6), omx026. https://doi.org/10.1093/omcr/omx026
Ban BH, et al. Opana-induced Thrombotic Microangiopathy Masquerading as Thrombotic Thrombocytopenic Purpura. Oxf Med Case Reports. 2017;2017(6):omx026. PubMed PMID: 28580158.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Opana-induced thrombotic microangiopathy masquerading as thrombotic thrombocytopenic purpura. AU - Ban,Byung H, AU - Verma,Ashish, AU - Tudor,Maria, AU - Sethi,Jigme, Y1 - 2017/06/01/ PY - 2016/11/28/received PY - 2017/03/01/revised PY - 2017/04/05/accepted PY - 2017/6/6/entrez PY - 2017/6/6/pubmed PY - 2017/6/6/medline SP - omx026 EP - omx026 JF - Oxford medical case reports JO - Oxf Med Case Reports VL - 2017 IS - 6 N2 - Opana (oxymorphone) is a powerful semi-synthetic opioid agonist used for chronic pain management that is ingested orally. However, improper injection of Opana can lead to a rare and fatal blood disorder known as thrombotic microangiopathy. Opana-induced thrombotic microangiopathy can be easily mistaken for thrombotic thrombocytopenic purpura (TTP), leading to the initiation of therapeutic plasma exchange. Current literature has conflicting views on the necessity of therapeutic plasma exchange for the treatment of Opana-induced thrombotic microangiopathy. In our case report, a 47-year-old Caucasian male was admitted with a presentation suspicious for TTP then underwent therapeutic plasma exchange without clinical improvement. With supportive treatment only, the patient eventually improved and later admitted to intravenously abusing oral Opana 1-2 days prior to becoming ill. SN - 2053-8855 UR - https://www.unboundmedicine.com/medline/citation/28580158/Opana_induced_thrombotic_microangiopathy_masquerading_as_thrombotic_thrombocytopenic_purpura_ L2 - https://academic.oup.com/omcr/article-lookup/doi/10.1093/omcr/omx026 DB - PRIME DP - Unbound Medicine ER -
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