Platelet adhesion to collagen in normal and von Willebrand's disease subjects.
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Biomedical subjects
Publications and source records attributed to R A Moss.
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A variety of drugs and other agents have been reported to cause immune-mediated platelet destruction. The cardinal features of this syndrome are acute, often alarming, purpura, closely related to drug exposure, which remits in one to two weeks after discontinuation of all suspect drugs. Quinidine and quinine have been most commonly implicated but, recently, both heparin and heroin have been the subject of numerous reports. Platelets are removed rapidly from the circulation, apparently as a result of the attachment of drug-antibody immune complexes. In vitro documentation of platelet injury by these complexes has inspired the development of many in vitro tests of differing sophistication. While valuable in confirming the clinical suspicion, none is sufficiently sensitive to exclude the diagnosis.
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Six cases of acute thrombocytopenic purpura occurred secondary to heroin abuse. Five of the six affected patients were seen over a six-month period between November 1977 and March 1978, and the last patient was seen in November 1978. The clinical manifestations were characteristic of drug-induced immune thrombocytopenia. We suspect this syndrome is related to a new adulterant added to local street heroin.
A case of necrosis of the soft tissue over the chin following mandibular advancement and genioplasty is presented. The aetiology, pathology, and clinical management of pressure sores is discussed.
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