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Vol. 29. Issue 6.
Pages 281-285 (August - September 1993)
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Vol. 29. Issue 6.
Pages 281-285 (August - September 1993)
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Obstrucción e hiperreactividad bronquial en relación con la inhalación de heroína y vapores de aluminio. Estudio de 20 casos
Bronchial obstruction and hyperreactivity in relation with inhalation of heroin and aluminium vapors. Study of 20 cases
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R. Otero Candelera, R. Sánchez Gil, F. Capote Gil, A. Pereira Vega, F. Hernández Utrera, J. Castillo Gómez
Servicio de Neumología. Hospital Universitario Virgen del Rocío. Sevilla
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La inhalación de vapores resultantes de calentar heroína sobre papel de aluminio es una variante de drogadicción relativamente extendida y ha sido relacionada por varios autores con la aparición de obstrucción e hiperreactividad bronquial.

Comparamos las características clínicas, radiológicas, funcionales y el potencial fondo atópico de un grupo de 20 sujetos adictos a heroína inhalada que presentaban crisis recortadas de disnea y sibilancias, con un grupo de 20 pacientes asmáticos elegidos al azar y de edad similar.

Los antecedentes personales de atopia, la positividad de los tests cutáneos frente a neumoalergenos habituales y la elevación de IgE total, presentes en la mayoría de nuestros pacientes asmáticos, fueron significativamente menos frecuentes en el grupo de adictos (p=0,0006, p < 0,0001 y p=0,0089, respectivamente).

Hallamos de forma más constante datos semiológicos de obstrucción bronquial difusa y reducción del índice FEV1/ FVC % basal en el grupo de heroinómanos (p < 0,0001 y p=0,0001).

Creemos que este tipo de hábito tóxico no actuaría como simple factor precipitante en individuos predispuestos sino como factor causal de la obstrucción e hiperreactividad bronquial.

The inhalation of vapors from the heating of heroin on aliminium paper is a variant of drug addiction which is relatively extended and has been related with the appearance of bronchial obstruction and hyperreactivity by serveral authors.

The clinical, radiologic and functional characteristics and the potential atopic background of a group of 20 subjects addicted to inhaled heroin who presented shortened crisis of dyspnea and sibilance were compared with a group of 20 asthmatic patients randomly chosen of a similar age.

The personal history of atopia, positivity of cutaneous tests versus habitual pneumoallergens and the elevation of total IgE present in most of the asthmatic patients were significantly less frequent in the group of addicts (p=0.0006, p < 0,0001 and p=0.0089, respectively).

Semiologic data of diffuse bronchial obstruction and reduction of the basal FEV1/FVC % rate was found to be more constant in the group of heroin addicts (p < 0.001 and p=0.0001).

The authors believe that this type of toxic habit does not act as a simple precipitating factor in predisposed individuals but rather acts as a causal factor of bronchial obstruction and hyperreactivity.

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Copyright © 1993. Sociedad Española de Neumología y Cirugía Torácica
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