Pulmonary Talcosis With Intravenous Drug Abuse

Clinical and pathologic characteristics of intranasal abuse of combined opioid‐acetaminophen medications

“…Talc is known to cause pulmonary disease and retinopathy secondary to intravenous administration of crushed tablets or direct inhalation of either talc powder or contaminated marijuana . Pulmonary talcosis is characterized by a foreign body giant cell reaction in the lungs surrounding polarizable birefringent crystals, and it is manifested by dyspnea and dry cough . The histology of the nasal pathology seen in our patients with birefringent polarizable material surrounded by inflammation is similar to the pathological findings of pulmonary talcosis .…”

“…Pulmonary talcosis is characterized by a foreign body giant cell reaction in the lungs surrounding polarizable birefringent crystals, and it is manifested by dyspnea and dry cough . The histology of the nasal pathology seen in our patients with birefringent polarizable material surrounded by inflammation is similar to the pathological findings of pulmonary talcosis . It is therefore very likely that talc from the crushed tablets is the polarizable material seen in the nasal biopsies, and that septal necrosis in our patients is due to the localized inflammatory response caused by talc.…”

Rapid development of pulmonary hypertension and right ventricular failure due to large vessel intravascular microcrystalline cellulosis in an intravenous drug user

“…The insoluble particulate matter occluded the capillary and distal arteriole beds, as has been described previously in cases of foreign material intravascular deposition. Unlike previously reported cases of foreign body granulomatosis associated with intravenous injection of crushed pills, [1][2][3] our case was characterized by rapid progression from no detectable disease to wide spread occlusion of the pulmonary vascular bed and death from right heart failure within months of illicit drug use through her central catheter. This likely occurred due to the occlusion of more proximal pulmonary arteries from larger particle size afforded by the larger lumenal diameter of the central line.…”

Surveillance for Silicosis Deaths Among Persons Aged 15–44 Years — United States, 1999–2015

“…Although only 240 workers were employed in talc mining in the United States during 2015 (the number of workers exposed to talc in milling and secondary industries is unknown), 803,000 metric tons of talc were used in various products that year. †† Nonoccupational exposure to talc dust has been associated with use of cosmetic talcum powder ( 4 ) and, importantly, with illicit intravenous or inhalation administration of talc-containing legal or illegal drugs, including marijuana, methamphetamine, methadone, promethazine, cocaine, diazepam, acetaminophen, meperidine, pentazocine, oxymorphone, and heroin ( 3 , 5 – 7 ).…”