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Puffy hand syndrome due to drug addiction: a casecontrol study of the pathogenesis
(Le lymphoedème des mains dû à linjection de drogues : une étude de cas contrôlés des pathogénèses.)
Auteur(s) :
V. ANDRESZ ;
N. MARCANTONI ;
F. BINDER ;
M. VELTEN ;
M. ALT ;
J. C. WEBER ;
D. STEPHAN
Article en page(s) :
1347-1351
Refs biblio. :
20
Domaine :
Drogues illicites / Illicit drugs
Langue(s) :
Anglais
Discipline :
PAT (Pathologie organique / Organic pathology)
Note générale :
Addiction, 2006, 101, (9), 1347-1351, tabl.
Résumé :
Aim: We studied the pathogenesis of puffy hand syndrome of intravenous drug use. We hypothesized that injections of high-dose sublingual buprenorphine, instead of the recommended sublingual administration, could play an important role in lymphatic obstruction and destruction. Design and participants: We set up a casecontrol study in substitution centres, recruiting intravenous drug addicts with and without puffy hands, respectively. The subjects were asked to answer anonymously a questionnaire of 40 items comprising social and demographic status, history of illicit drugs use, buprenorphine misuse and injection practices. Findings: We included 33 cases and 33 controls, mean age of 34 years. They were past heroin users, mainly methadone-substituted. In multivariate analysis, sex (women) (OR = 8.9, P = 0.03), injections in the hands (OR = 5.9, P = 0.03), injections in the feet (OR = 6.5, P = 0.01) and the absence of tourniquet (OR = 7.0, p = 0.02) were significant risk factors for puffy hand syndrome. In 69.7% of the cases and 59.4% of the controls, respectively, there was a high-dose sublingual buprenorphine misuse, although it appeared not to be a significant risk factor for puffy hand syndrome. Conclusions: Injection practices are likely to cause puffy hands syndrome, but buprenorphine misuse should not be considered as a significant risk factor. However, intravenous drug users must still be warned of local and systemic complications of intravenous drug misuse. (Author' s abstract)
Affiliation :
Service Hypertension Maladies vasculaires Pharmacologie clinique, Hôpitaux Universitaires de Strasbourg, 67091 Strasbourg cedex,
France. France.
France. France.
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