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Panlobular emphysema in young intravenous Ritalin abusers
R A Schmidt1, R W Glenny, J D Godwin
1Department of Pathology, University of Washington, School of Medicine, Seattle 98195.
The American Review of Respiratory Disease
|March 1, 1991
Summary
Young intravenous Ritalin abusers can develop severe emphysema. Pathological examination revealed microscopic talc granulomas, suggesting a novel cause for lung disease distinct from alpha-1-antitrypsin deficiency.
Area of Science:
- Pulmonary Medicine
- Toxicology
- Pathology
Background:
- Intravenous Ritalin abuse is associated with severe obstructive lung disease.
- The underlying pathology of this emphysema has not been previously investigated.
Purpose of the Study:
- To investigate the pathologic basis of emphysema in young intravenous Ritalin abusers.
- To differentiate the cause of emphysema from alpha-1-antitrypsin deficiency.
Main Methods:
- Autopsy of seven deceased patients with detailed lung examination (radiological, gross, microscopic, electron probe X-ray microanalysis).
- Testing of living patients for alpha-1-antitrypsin deficiency.
Main Results:
- All seven patients exhibited severe panlobular emphysema, more pronounced in lower lung zones.
- Microscopic talc granulomas were consistently found, with variable vascular involvement.
- No significant interstitial fibrosis was observed; alpha-1-antitrypsin deficiency was ruled out.
Conclusions:
- Intravenous Ritalin abuse can lead to emphysema resembling alpha-1-antitrypsin deficiency but with a different pathogenesis.
- Talc from Ritalin tablets is a potential contributing factor, though the exact mechanism requires further study.