Acute Painful Neuropathy in a Heroin Body Packer

Abstract

Dear Editor, A broad range of peripheral neurological complications have been recognized in heroin addicts. Peripheral nervous system (PNS) involvement [1,2], usually secondary to trauma during loss of consciousness, commonly manifests as compressive neuropathy or rhabdomyolysis. Other rare, nontraumatic PNS lesions include poliradiculopathy, plexopathy, Guillan–Barre syndrome, and mononeuropathy. Acute heroin-related noncompressive neuropathy is rare, and the etiology is still unclear [3]. In heroin abusers, painful acute neuropathy has rarely been described. We report the case of a 33-year-old male with a history of heroin abuse. He was found in his home in coma, maintaining the same sitting position for several hours. He was admitted to the intensive care unit where rhabdomyolysis complicated by acute renal failure was diagnosed, requiring treatment with hemodialysis. A computed tomography scan of the abdomen (Figure ⇓) revealed the presence of several foreign bodies in sigma, and the urinary exams showed high concentration of opiates, revealing that the patient was a body packer. Further laboratory exams showed hepatitis C virus (HCV) infection with normal liver function. Figure 1 Computed tomography scan of the abdomen showing the presence of several foreign bodies in sigma. Upon awakening, 5 days after admission, the patient complained of severe burning pain, mechanical allodynia, itch, tingling, and …