heroin and Drug-Hypersensitivity

Topics: Animals; Anti-Glomerular Basement Membrane Disease; Anti-Inflammatory Agents; Antibodies; Captopril; Drug Hypersensitivity; Environmental Exposure; Glomerulonephritis; Gold; Heroin; Humans; Hydrocarbons; Hypersensitivity, Delayed; Hypersensitivity, Immediate; Immune Complex Diseases; Kidney Diseases; Kidney Glomerulus; Lupus Erythematosus, Systemic; Mercury; Nephritis, Interstitial; Penicillamine; Penicillins; Rifampin

Topics: Adrenal Cortex Hormones; Aerosols; Analgesics; Aspirin; Autonomic Agents; Bleomycin; Busulfan; Contraceptives, Oral; Cyclophosphamide; Dextropropoxyphene; Drug Hypersensitivity; Heroin; Humans; Lung Diseases; Lupus Erythematosus, Systemic; Methadone; Methotrexate; Mineral Oil; Nitrofurantoin; Oxygen Inhalation Therapy; Paraquat; Pituitary Gland, Posterior; Pleural Effusion; Sulfonamides; Tissue Extracts

Topics: Air Pollution; Analgesics; Animals; Anti-Bacterial Agents; Anticoagulants; Anticonvulsants; Breast; Breast Feeding; Bromides; Contraceptives, Oral; Diuretics; Drug Hypersensitivity; Drug-Related Side Effects and Adverse Reactions; Enzyme Induction; Female; Heroin; Hormones; Humans; Hydrogen-Ion Concentration; Hypnotics and Sedatives; Infant; Infant, Newborn; Lactation; Lithium; Milk, Human; Pharmaceutical Preparations; Pregnancy; Rabbits; Rats; Smoking; Tranquilizing Agents

Across Europe, illicit drug-related mortality has not declined despite ever increasing prevention measures. The cause of these deaths has traditionally been associated with overdose. Previous findings have revealed the appearance of non-lethal opioid concentrations, leading us to investigate a further cause of death. The symptoms of heroin intoxication with asphyxia and/or cardiovascular involvement resemble anaphylaxis, and therefore it has been speculated that such deaths might be caused by an allergic reaction. The study´s aims were to investigate levels of allergic mediators in long-term injecting drug users (IDU) compared to healthy controls and to determine if oral opioid substitution therapy (OST) resulted in similar allergic symptoms to those reported by IDU after intravenous (IV) heroin use.. We quantified the concentrations of histamine, diamine oxidase (DAO), tryptase and lipoprotein-associated phospholipase A2 (LpPLA2) at baseline and 1 h after administration of Substitol®retard (482 ± 220 mg) in 56 patients at a withdrawal centre (Austria) and compared them with healthy controls (n = 103). Questionnaires and face-to-face interviews were used to assess allergic symptoms and side effects in IDU. Descriptive statistical analyses of quantitative data were performed by using SPSS.. Baseline histamine, tryptase and LpPLA2 were significantly elevated in IDU compared to the healthy control group, while DAO decreased. Blood levels showed no significant change after oral substitution uptake. Self-reported allergic symptoms and side effects after IV heroin use were reported in 55 cases (98.2%), minimal symptoms were documented after OST (12.5%, 7/56).. This study revealed that baseline histamine concentrations were elevated in chronic IDU, although only relatively small changes in tryptase plasma levels occurred. After IV heroin application the reported allergic symptoms were mostly mild and did not lead to clinically relevant side effects. The substitution substance was clearly better tolerated than IV administered heroin. Elevated levels of allergic mediators such as histamine in IDUs may place them at greater risk of severe or fatal anaphylaxis when exposed to heroin; however, this requires further investigation.

Topics: 1-Alkyl-2-acetylglycerophosphocholine Esterase; Adolescent; Adult; Amine Oxidase (Copper-Containing); Biomarkers; Case-Control Studies; Drug Hypersensitivity; Female; Heroin; Histamine; Humans; Male; Middle Aged; Morphine; Opiate Substitution Treatment; Opioid-Related Disorders; Substance Abuse, Intravenous; Tryptases; Young Adult

The value of skin prick testing in opiate-sensitive individuals is uncertain as opiates cause non-specific weals by direct degranulation of mast cells.. To define whether skin prick test (SPT) responses to opiates in opiate-sensitive individuals are different to those seen in the normal population and to describe the clinical characteristics of this group of subjects.. The SPT responses of eight opiate-sensitive subjects to morphine 10 mg/mL, pethidine (meperidine) 50 mg/mL and papaveretum 15.4 mg/mL at four different concentrations (undiluted, 1/10, 1/50 and 1/100) were compared with the responses of 100 (32 atopic) non-opiate-sensitive control subjects. Four of the opiate-sensitive subjects had a clinical history of asthma, rhinitis or urticaria on occupational exposure to morphine. One subject developed urticaria with codeine, one developed urticaria and asthma with morphine and diamorphine and two subjects reacted to intravenous papaveretum with anaphylaxis or urticaria. Five out of the eight cases had opiate sensitivity confirmed by single-blind placebo-controlled oral challenge.. Skin prick tests to all three opiates were not significantly different when the eight opiate-sensitive subjects were compared with either the entire normal control group or the subgroup of 47 definite opiate-tolerant controls that had previously received opiates for clinical indications. Furthermore, there were no significant differences in size of opiate SPT responses between atopic and non-atopic control subjects. In the control subjects, there was a positive correlation in SPT weal size between the three opiates.. Skin prick testing is not useful in the diagnosis of opiate sensitivity and placebo-controlled challenge should be considered.

Topics: Adult; Aged; Aged, 80 and over; Allergens; Asthma; Codeine; Drug Hypersensitivity; Female; Heroin; Humans; Male; Meperidine; Middle Aged; Morphine; Narcotics; Occupational Diseases; Opium; Rhinitis; Skin Tests; Urticaria

Topics: Administration, Intranasal; Adult; Biopsy; Drug Hypersensitivity; Female; Heroin; Heroin Dependence; Humans; Lung; Lung Volume Measurements; Narcotics; Pneumonia

Topics: Asthma; Drug Hypersensitivity; Heroin; Humans; Immunoglobulin E; India; Male; Middle Aged; Urticaria

A case is described of a young man who presented with acute pulmonary edema and flaccid paralysis of the right upper and lower extremity, following his first injection of heroin and was found in a comatose state. Needle electromyographic findings were compatible with a severe lesion of the right brachial plexus and a moderate lesion of the right lumbar plexus. An allergic or a hypersensitivity reaction might have been the possible cause.

Topics: Acute Disease; Adult; Brachial Plexus; Drug Hypersensitivity; Heroin; Humans; Inflammation; Lumbosacral Plexus; Male; Paralysis; Pulmonary Edema

Description of a case of benign acute transverse myelopathy in a young woman who had taken heroin I.V. after a two-year free interval. Spinal angiography was negative but CT scanning of the cord showed a swelling at C3.

Topics: Acute Disease; Adult; Drug Hypersensitivity; Female; Heroin; Humans; Hypesthesia; Injections, Intravenous; Paraplegia; Spinal Cord Diseases; Substance Withdrawal Syndrome

Drug-induced lung diseases may present themselves as bronchial reactions (e.g. bronchial asthma), diseases of the parenchyma (e.g. pulmonary infiltrates with eosinophilia, diffuse fibrosing alveolitis), of the pulmonary vasculature (vasculitis) and of the pleura (e.g. pleurisy or pleural fibrosis). Pathogenetically the two most pertinent types of reaction are hypersensitivity or toxic reactions, and less often biologic reactions such as opportunistic infections after cytotoxic and immunosuppressive therapy. Many drug-induced respiratory diseases are reversible upon withdrawal of the offending agent; others may be irreversible or even progress.

Topics: Aspirin; Asthma; Bronchitis; Busulfan; Contraceptives, Oral, Hormonal; Dose-Response Relationship, Drug; Drug Hypersensitivity; Drug Interactions; Drug Tolerance; Heroin; Humans; Iodides; Lung Diseases; Methysergide; Pituitary Hormones, Posterior; Pleural Diseases; Polyarteritis Nodosa; Pulmonary Edema; Pulmonary Embolism; Pulmonary Eosinophilia; Trypsin

Topics: Adult; Brain Diseases; Deglutition Disorders; Dexamethasone; Drug Hypersensitivity; Heroin; Humans; Male; Pons; Quadriplegia; Speech Disorders; Spinal Cord Diseases; Substance-Related Disorders

Topics: Adult; Carotid Artery Diseases; Carotid Artery, Internal; Cerebral Angiography; Cerebrovascular Disorders; Drug Hypersensitivity; Electroencephalography; Female; Hemiplegia; Heroin; Humans; Substance-Related Disorders

Topics: Adult; Barbiturates; Cocaine; Drug Hypersensitivity; Heroin; Humans; Male; Middle Aged; Morphine Dependence; Substance-Related Disorders