Pulmonary talc granulomatosis. A complication of drug abuse

Our plain-English summary of Pulmonary talc granulomatosis. A complication of drug abuse, by G.B. Hopkins, D.G. Taylor (The American Review of Respiratory Disease, 1970).

The study

• Authors: G.B. Hopkins, D.G. Taylor
• Journal: The American Review of Respiratory Disease
• Published: 1970;101(1):101-4
• Cited by: 57 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 002458).

In plain English

This article reported two cases of pulmonary talc granulomatosis in men who had injected methylphenidate (Ritalin) tablets into their veins. Granulomatosis here means small clusters of inflammatory cells forming in the lungs in reaction to talc particles. The authors explained that talc is used as a filler in the tablets. The first patient was a 49-year-old man who had injected dissolved methylphenidate tablets for one year. He had part of his left lung removed after a lesion was seen on a chest film, and it proved to be an undifferentiated malignant tumor. The surrounding lung contained numerous granulomas in and around blood vessels. These held crystalline material that looked like talc under the microscope. The second patient was a 26-year-old man who had injected two crushed tablets three or four times a day for one year. A lung lobe was removed because of bleeding from an infected aneurysm (a bulge in an artery wall) in a lung artery. His lung showed identical granulomas and a slight degree of vascular sclerosis (hardening of the vessels). The authors called the lesion serious and attributed it to talc.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (two cases)
• Who was studied: Two men (described in the article as Negro males), aged 49 and 26, admitted to hospital in 1969 and 1968
• Exposure: Intravenous injection of methylphenidate tablets, which contain talc as a filler; about one year of injecting in each case (Case 2: two crushed tablets three or four times daily)
• Main results:
  • Case 1: the lung nodule was an undifferentiated malignant neoplasm
  • Case 1: the surrounding lung had granulomas containing birefringent crystalline material with the typical appearance of talc
  • Case 2: a 5- by 2.5- by 1.5-cm saccular mycotic aneurysm of the lobar artery was found
  • Case 2: cultures of the aneurysm grew Klebsiella species
  • Case 2: granulomas were identical to those in Case 1, with slight pulmonary vascular sclerosis
• The authors' conclusion: The authors concluded that the lesion is serious and attributed it to the talc used as filler in the tablets

Topics

The National Library of Medicine indexes this study under subjects our site covers: Talc and vermiculite.

Medical terms in this study, explained in our Lexicon: Talc.

Related studies

• Pulmonary granulomatous reaction: talc pneumoconiosis or chronic sarcoidosis? — P. Tukiainen, J. Nickels, et al. (1984)
• Talc: understanding its manifestations in the chest — D.S. Feigin (1986)
• Morbidity and Mortality in Talc Granuloma: Report of a Fatal Case — A.J. Swingle (1948)
• Pulmonary response, in vivo, to silicon carbide whiskers — G.L. Vaughan, S.A. Trently, et al. (1993)
• On talc, tremolite, and tergiversation. Ter-gi-ver-sate: 2: to use subterfuges — B.W. Case (1991)
• On talc, tremolite, and tergiversation — A.M. Langer, R.P. Nolan, et al. (1991)

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