Thrombocytopenic purpura in narcotics addicts.

Important note: Information in this article was accurate in 1985. The state of the art may have changed since the publication date.

Thrombocytopenic purpura in narcotics addicts.

Ann Intern Med. 1985 Jun;102(6):737-41. Unique Identifier : AIDSLINE MED/85197242
Savona S; Nardi MA; Lennette ET; Karpatkin S

Abstract: Since November 1982 we have seen an association of thrombocytopenic purpura with chronic narcotic addiction in 70 patients with a mean platelet count of 53000 +/- 4000 (SE); 33 had stopped taking intravenous drugs for an average of 21.2 +/- 4.7 months; 13 of 15 had elevated antibody titers for a virus related to the acquired immunodeficiency syndrome. Platelet-bound IgG, IgM, and complement levels were 16.7-, 5.6-, and 3.1-fold greater than control values, respectively, and 2.6-, 1.9-, and 2.4-fold greater than values in 25 patients with classic autoimmune thrombocytopenic purpura studied at the same time. Thirty-three of thirty-six addicts had elevated circulating immune complexes, whereas 8 patients with autoimmune thrombocytopenia had no elevation. Eleven of eighteen addicts had positive serum platelet-reactive IgG titers, compared to 5 of 19 patients with classic autoimmune thrombocytopenia. The platelet-reactive IgG in sera of addicts was composed of 7S IgG antibody as well as high molecular weight (immune complex) IgG. Thus, chronic addicts appear to have a new immunologic platelet disorder associated with the presence of 7S IgG antiplatelet antibody, like patients with classic autoimmune thrombocytopenic purpura, and immune complex associated nonspecific platelet IgG, like male homosexual patients with thrombocytopenia.

Keywords: Acquired Immunodeficiency Syndrome/IMMUNOLOGY Adult Antibodies, Viral/ANALYSIS Antigen-Antibody Complex/ANALYSIS Autoantibodies/ANALYSIS Blood Platelets/IMMUNOLOGY Cocaine Complement/ANALYSIS Female Heroin Dependence/COMPLICATIONS Human HTLV-BLV Viruses/IMMUNOLOGY IgG/ANALYSIS IgM/ANALYSIS Injections, Intravenous Male Narcotic Dependence/*COMPLICATIONS Purpura, Thrombocytopenic/*ETIOLOGY/IMMUNOLOGY Substance Dependence/COMPLICATIONS Support, Non-U.S. Gov't Support, U.S. Gov't, P.H.S. JOURNAL ARTICLE

850830
M8580014

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