Titanium pigment in tissues of drug addicts: report of 5 necropsied cases

Abstract

The aim of this report is to describe the anatomic-pathologic findings from necropsies of 5 drug addicts with titanium pigment in several organs after chronic intravenous injection of crushed propoxyphene hydrochloride tablets. Samples from liver, spleen, lungs, lymph nodes, and bone marrow were obtained, and after being grossly studied, they were submitted to evaluation using common light and polarized microscopy. In all 5 cases, a pigment with characteristics of titanium dioxide was found within tissue samples of the organs studied. Our findings suggest that research concerning titanium pigment within body tissues should be enhanced, considering the potential contribution of this morphologic data to forensic pathology.

Tampering with Prescription Opioids: Nature and Extent of the Problem, Health Consequences, and Solutions

“…IV injection of preparations intended for nonparenteral use is also associated with a deleterious impact on respiratory function due to talc or other excipients (35)(36)(37), as well as other organ damage (38).…”

Pulmonary intravascular talcosis mimicking miliary tuberculosis in an intravenous drug addict

“…This misdiagnosis most probably occurred due to the pressure by patient-related and regional prejudice and because the test results not indicating the presence of M tuberculosis were overlooked. Apart from talc, oral medications may also contain other water-insoluble fillers and binders like cellulose,13 14 methylcellulose,3 crosprovidone3 and titanium dioxide 12. All water-insoluble particulate substances reach the lungs, which act as a capillary filter.…”

“…As several foreign materials can cause a similar micronodular pattern of PFBG,3 12 13 the exact causative agent could only be determined by SLB. Typically, in SLB sections of patients with pulmonary IT, fine, birefringent, needle-shaped talc particles can be seen inside the giant cells along with perivascular and peribronchial fibrosis 2 15.…”

Titanium Pigment and Yellow Nail Syndrome

“…I would like to add some comments about a study of 5 Brazilian patients with necropsy findings of titanium deposits in samples of liver, spleen, lungs, lymph nodes, and bone marrow [5] , but without any change, neither in color nor in the structure of the nails. The origin of deposits detected by studies utilizing common light and polarized microscopy was chronic intravenous injection of crushed propoxyphene hydrochloride tablets containing minerals like basic silicate of magnesium and calcium, in addition to titanium as excipients [5] .…”

“…The origin of deposits detected by studies utilizing common light and polarized microscopy was chronic intravenous injection of crushed propoxyphene hydrochloride tablets containing minerals like basic silicate of magnesium and calcium, in addition to titanium as excipients [5] . Moreover, the characterization of titanium pigment was based on the optical microscopy qualities of the mineral, which appears white with the reflected light, black with the transmitted light, and pink under polarized light [5] . Noteworthy was the lack of yellow nail changes, despite the chronic presence of titanium in the entire body.…”