Work

Rapid development of pulmonary hypertension and right ventricular failure due to large vessel intravascular microcrystalline cellulosis in an intravenous drug user

Year: 2020

Type: article

Abstract: Intravascular foreign body deposition in the form of talc or microcrystalline cellulose is an uncommon but increasing cause of pulmonary hypertension given the current opioid epidemic. Earlier cases describe the effect of talc introduced via intravenous injection of crushed pills when deposited throughout the lungs, typically in the capillaries or distal pulmonary arterioles. An angiogranulomatous reaction ensues with pulmonary vascular remodeling and the gradual development of pulmonary hypertension. Although the use of talc in the manufacture of tablets has largely been replaced with alternative inert binders including microcrystalline cellulose, a similar angiogranulomatous reaction and vascular remodeling can occur. We report a case of intravascular microcrystalline cellulosis that rapidly progressed to fatal pulmonary hypertension over months characterized by occlusion of more proximal pulmonary arterioles in an intravenous drug user.

Source: Pulmonary Circulation

DOI: 10.1177/2045894020907871

Authors: Tim Amass, Jeffrey Cumplido, Basam Aswad, Mary Whittenhall, Corey Ventetuolo, James Klinger

Institution: Brown University

Language: English

Topic: Pulmonary Hypertension Research and Treatments

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,000