Abstract
Substance use
disorders may have dramatic consequences. We report a case of acute multiple
organ fairly related to heroin and cocaine-"Crack" consumption.
A 27-year-old
man was brought to emergency department unconscious with history of drug abuse.
On physical examination his Glasgow coma scale was 10. On neurologic
examination besides unresponsiveness bilateral reactive mydriatic pupils were
detected. Blood gas analyses showed metabolic acidosis with pH 7.19, Lac: 10
and K+:7.6. Blood biochemistry showed acute kidney fairly; Cr: 2.56, and acute
hepatic injury: ALT: 2597 and AST 1795, amylase 700. Blood ethanol level was
within legal levels: 3.8.
Computed
tomography of brain performed in order to evaluate central disorder showed no
abnormality and magnetic resonance imaging of brain reported internal border
zone ischemia.
Despite flood
resuscitation organ dysfunction sustained: Urea: 62, Cr: 3.7, ALT>2215,
AST>1800, CK: 432, CK-MB 474, CRP: 106, INR: 1.29, and hematuria presented.
Narcotic screening reported opiate and cocaine presence. He was taken to
dialysis program.
The patient
suffered a tonic seizure during observation which was treated with 5 mg
diazepam intravenously.
After totally 7
dialyses liver enzymes reduced, however kidney fairly remained. On day 8 renal
parameters were urea: 60 and Cr: 7 and he was discharged from intensive unite.
That drugs
affect many systems separately is known, but with this case we wanted to
emphasize that such chemicals may lead to a chain of reactions resulting with
multiple organ dysfunctions.
References
- Oya GÜVEN, Feruza TURAN SÖNMEZ, Dilay SATILMIŞ, Harun GÜNEŞ
- Medical Park Hospital, Department of Emergency Medicine, Istanbul, Turkey Duzce School of Medicine, Department of Emergency Medicine, Duzce, Turkey Esenyurt State Hospital, Department of Emergency Medicine, Istanbul, Turkey
Abstract
References
- Oya GÜVEN, Feruza TURAN SÖNMEZ, Dilay SATILMIŞ, Harun GÜNEŞ
- Medical Park Hospital, Department of Emergency Medicine, Istanbul, Turkey Duzce School of Medicine, Department of Emergency Medicine, Duzce, Turkey Esenyurt State Hospital, Department of Emergency Medicine, Istanbul, Turkey
Details
| Journal Section | Articles |
|---|---|
| Authors | |
| Publication Date | February 16, 2017 |
| Published in Issue | Year 2017 Volume: Volume 2 Issue: İssue 1 (1) - 2.İnternational Congress Of Forensic Toxicology |
