Puffy hand syndrome due to drug addiction: a case–control study of the pathogenesis
Identifieur interne : 007805 ( Istex/Corpus ); précédent : 007804; suivant : 007806Puffy hand syndrome due to drug addiction: a case–control study of the pathogenesis
Auteurs : Valérie Andresz ; Nicolas Marcantoni ; Florence Binder ; Michel Velten ; Martine Alt ; Jean-Christophe Weber ; Dominique StephanSource :
- Addiction [ 0965-2140 ] ; 2006-09.
Abstract
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.
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DOI: 10.1111/j.1360-0443.2006.01521.x
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Santé publique EA 1801, Faculté de Médecine,</mods:affiliation></affiliation></author><author><name sortKey="Velten, Michel" sort="Velten, Michel" uniqKey="Velten M" first="Michel" last="Velten">Michel Velten</name><affiliation><mods:affiliation>Laboratoire d’épidémiologie et de Santé publique EA 1801, Faculté de Médecine,</mods:affiliation></affiliation></author><author><name sortKey="Alt, Martine" sort="Alt, Martine" uniqKey="Alt M" first="Martine" last="Alt">Martine Alt</name><affiliation><mods:affiliation>Centre de Pharmacovigilance</mods:affiliation></affiliation></author><author><name sortKey="Weber, Jean Hristophe" sort="Weber, Jean Hristophe" uniqKey="Weber J" first="Jean-Christophe" last="Weber">Jean-Christophe Weber</name><affiliation><mods:affiliation>and Médecine interne A, Hôpitaux Universitaires, Université Louis Pasteur, Strasbourg, France</mods:affiliation></affiliation></author><author><name sortKey="Stephan, Dominique" sort="Stephan, Dominique" uniqKey="Stephan D" 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type="first">Nicolas</forename><surname>Marcantoni</surname></persName><affiliation>Hypertension Maladies vasculaires Pharmacologie clinique, Hôpitaux Universitaires,</affiliation></author><author xml:id="author-0002"><persName><forename type="first">Florence</forename><surname>Binder</surname></persName><affiliation>Laboratoire d’épidémiologie et de Santé publique EA 1801, Faculté de Médecine,</affiliation></author><author xml:id="author-0003"><persName><forename type="first">Michel</forename><surname>Velten</surname></persName><affiliation>Laboratoire d’épidémiologie et de Santé publique EA 1801, Faculté de Médecine,</affiliation></author><author xml:id="author-0004"><persName><forename type="first">Martine</forename><surname>Alt</surname></persName><affiliation>Centre de Pharmacovigilance</affiliation></author><author xml:id="author-0005"><persName><forename type="first">Jean‐Christophe</forename><surname>Weber</surname></persName><affiliation>and Médecine interne A, Hôpitaux Universitaires, Université Louis Pasteur, Strasbourg, France<address><country key="FR"></country></address></affiliation></author><author xml:id="author-0006" role="corresp"><persName><forename type="first">Dominique</forename><surname>Stephan</surname></persName><affiliation>Hypertension Maladies vasculaires Pharmacologie clinique, Hôpitaux Universitaires,</affiliation><affiliation>Centre de Pharmacovigilance</affiliation><affiliation>Dominique Stephan, Service Hypertension Maladies vasculaires Pharmacologie clinique, Hôpitaux Universitaires de Strasbourg, 67091 Strasbourg cedex, France. E‐mail: dominique.stephan@chru‐strasbourg.fr</affiliation></author><idno type="istex">FF9CD93E8CB3CA280F1D191D78F26423A34E2C62</idno><idno type="DOI">10.1111/j.1360-0443.2006.01521.x</idno><idno type="unit">ADD1521</idno><idno type="toTypesetVersion">file:ADD.ADD1521.pdf</idno></analytic><monogr><title level="j" type="main">Addiction</title><title level="j" type="alt">ADDICTION</title><idno type="pISSN">0965-2140</idno><idno type="eISSN">1360-0443</idno><idno type="book-DOI">10.1111/(ISSN)1360-0443</idno><idno type="book-part-DOI">10.1111/add.2006.101.issue-9</idno><idno type="product">ADD</idno><idno type="publisherDivision">ST</idno><imprint><biblScope unit="vol">101</biblScope><biblScope unit="issue">9</biblScope><biblScope unit="page" from="1347">1347</biblScope><biblScope unit="page" to="1351">1351</biblScope><biblScope unit="page-count">5</biblScope><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2006-09"></date></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><abstract xml:lang="en" style="main"><head>ABSTRACT</head><p><hi rend="bold">Aim </hi> 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.</p><p><hi rend="bold">Design and participants </hi> We set up a case–control 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.</p><p><hi rend="bold">Findings </hi> 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, <hi rend="italic">P </hi>= 0.03), injections in the hands (OR = 5.9, <hi rend="italic">P</hi> = 0.03), injections in the feet (OR = 6.5, <hi rend="italic">P</hi> = 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.</p><p><hi rend="bold">Conclusions </hi> 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.</p></abstract><textClass><keywords xml:lang="en"><term xml:id="k1">Buprenorphine</term><term xml:id="k2">intravenous drug use</term><term xml:id="k3">puffy hand syndrome</term></keywords><classCode scheme="tocHeading1">RESEARCH REPORTS</classCode></textClass><langUsage><language ident="EN"></language></langUsage></profileDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/FF9CD93E8CB3CA280F1D191D78F26423A34E2C62/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Blackwell Publishing Ltd</publisherName><publisherLoc>Oxford, UK</publisherLoc></publisherInfo><doi origin="wiley" registered="yes">10.1111/(ISSN)1360-0443</doi><issn type="print">0965-2140</issn><issn type="electronic">1360-0443</issn><idGroup><id type="product" value="ADD"></id><id type="publisherDivision" value="ST"></id></idGroup><titleGroup><title type="main" sort="ADDICTION">Addiction</title></titleGroup></publicationMeta><publicationMeta level="part" position="09009"><doi origin="wiley">10.1111/add.2006.101.issue-9</doi><numberingGroup><numbering type="journalVolume" number="101">101</numbering><numbering type="journalIssue" number="9">9</numbering></numberingGroup><coverDate startDate="2006-09">September 2006</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="19" status="forIssue"><doi origin="wiley">10.1111/j.1360-0443.2006.01521.x</doi><idGroup><id type="unit" value="ADD1521"></id></idGroup><countGroup><count type="pageTotal" number="5"></count></countGroup><titleGroup><title type="tocHeading1">RESEARCH REPORTS</title></titleGroup><eventGroup><event type="firstOnline" date="2006-07-07"></event><event type="publishedOnlineFinalForm" date="2006-08-08"></event><event type="xmlConverted" agent="Converter:BPG_TO_WML3G version:2.3.2 mode:FullText source:FullText result:FullText" date="2010-02-26"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:4.0.1" date="2014-03-14"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-10-14"></event></eventGroup><numberingGroup><numbering type="pageFirst" number="1347">1347</numbering><numbering type="pageLast" number="1351">1351</numbering></numberingGroup><correspondenceTo>Dominique Stephan, Service Hypertension Maladies vasculaires Pharmacologie clinique, Hôpitaux Universitaires de Strasbourg, 67091 Strasbourg cedex, France. E‐mail: <email normalForm="dominique.stephan@chru-strasbourg.fr">dominique.stephan@chru‐strasbourg.fr</email></correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:ADD.ADD1521.pdf"></link></linkGroup></publicationMeta><contentMeta><unparsedEditorialHistory>Submitted 3 November 2005; initial review completed 6 February 2006; final version accepted 29 March 2006</unparsedEditorialHistory><countGroup><count type="figureTotal" number="1"></count><count type="tableTotal" number="3"></count><count type="formulaTotal" number="0"></count><count type="referenceTotal" number="20"></count><count type="wordTotal" number="3455"></count><count type="linksPubMed" number="0"></count><count type="linksCrossRef" number="0"></count></countGroup><titleGroup><title type="main">Puffy hand syndrome due to drug addiction: a case–control study of the pathogenesis</title><title type="shortAuthors">Valérie Andresz <i>et al.</i></title><title type="short">Puffy hand syndrome in drug addiction</title></titleGroup><creators><creator creatorRole="author" xml:id="cr1" affiliationRef="#a1"><personName><givenNames>Valérie</givenNames><familyName>Andresz</familyName></personName></creator><creator creatorRole="author" xml:id="cr2" affiliationRef="#a1"><personName><givenNames>Nicolas</givenNames><familyName>Marcantoni</familyName></personName></creator><creator creatorRole="author" xml:id="cr3" affiliationRef="#a2"><personName><givenNames>Florence</givenNames><familyName>Binder</familyName></personName></creator><creator creatorRole="author" xml:id="cr4" affiliationRef="#a2"><personName><givenNames>Michel</givenNames><familyName>Velten</familyName></personName></creator><creator creatorRole="author" xml:id="cr5" affiliationRef="#a3"><personName><givenNames>Martine</givenNames><familyName>Alt</familyName></personName></creator><creator creatorRole="author" xml:id="cr6" affiliationRef="#a4"><personName><givenNames>Jean‐Christophe</givenNames><familyName>Weber</familyName></personName></creator><creator creatorRole="author" xml:id="cr7" affiliationRef="#a1 #a3" corresponding="yes"><personName><givenNames>Dominique</givenNames><familyName>Stephan</familyName></personName></creator></creators><affiliationGroup><affiliation xml:id="a1"><unparsedAffiliation>Hypertension Maladies vasculaires Pharmacologie clinique, Hôpitaux Universitaires,</unparsedAffiliation></affiliation><affiliation xml:id="a2"><unparsedAffiliation>Laboratoire d’épidémiologie et de Santé publique EA 1801, Faculté de Médecine,</unparsedAffiliation></affiliation><affiliation xml:id="a3"><unparsedAffiliation>Centre de Pharmacovigilance</unparsedAffiliation></affiliation><affiliation xml:id="a4" countryCode="FR"><unparsedAffiliation>and Médecine interne A, Hôpitaux Universitaires, Université Louis Pasteur, Strasbourg, France</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en"><keyword xml:id="k1">Buprenorphine</keyword><keyword xml:id="k2">intravenous drug use</keyword><keyword xml:id="k3">puffy hand syndrome</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><title type="main">ABSTRACT</title><p><b>Aim </b> 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.</p><p><b>Design and participants </b> We set up a case–control 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.</p><p><b>Findings </b> 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, <i>P </i>= 0.03), injections in the hands (OR = 5.9, <i>P</i> = 0.03), injections in the feet (OR = 6.5, <i>P</i> = 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.</p><p><b>Conclusions </b> 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.</p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Puffy hand syndrome due to drug addiction: a case–control study of the pathogenesis</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Puffy hand syndrome in drug addiction</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Puffy hand syndrome due to drug addiction: a case–control study of the pathogenesis</title></titleInfo><name type="personal"><namePart type="given">Valérie</namePart><namePart type="family">Andresz</namePart><affiliation>Hypertension Maladies vasculaires Pharmacologie clinique, Hôpitaux Universitaires,</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Nicolas</namePart><namePart type="family">Marcantoni</namePart><affiliation>Hypertension Maladies vasculaires Pharmacologie clinique, Hôpitaux Universitaires,</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Florence</namePart><namePart type="family">Binder</namePart><affiliation>Laboratoire d’épidémiologie et de Santé publique EA 1801, Faculté de Médecine,</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Michel</namePart><namePart type="family">Velten</namePart><affiliation>Laboratoire d’épidémiologie et de Santé publique EA 1801, Faculté de Médecine,</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Martine</namePart><namePart type="family">Alt</namePart><affiliation>Centre de Pharmacovigilance</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jean‐Christophe</namePart><namePart type="family">Weber</namePart><affiliation>and Médecine interne A, Hôpitaux Universitaires, Université Louis Pasteur, Strasbourg, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Dominique</namePart><namePart type="family">Stephan</namePart><affiliation>Hypertension Maladies vasculaires Pharmacologie clinique, Hôpitaux Universitaires,</affiliation><affiliation>Centre de Pharmacovigilance</affiliation><affiliation>E-mail: dominique.stephan@chru‐strasbourg.fr</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Blackwell Publishing Ltd</publisher><place><placeTerm type="text">Oxford, UK</placeTerm></place><dateIssued encoding="w3cdtf">2006-09</dateIssued><edition>Submitted 3 November 2005; initial review completed 6 February 2006; final version accepted 29 March 2006</edition><copyrightDate encoding="w3cdtf">2006</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">1</extent><extent unit="tables">3</extent><extent unit="references">20</extent><extent unit="words">3455</extent></physicalDescription><abstract>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.</abstract><abstract>Design and participants We set up a case–control 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.</abstract><abstract>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.</abstract><abstract>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.</abstract><subject lang="en"><genre>keywords</genre><topic>Buprenorphine</topic><topic>intravenous drug use</topic><topic>puffy hand syndrome</topic></subject><relatedItem type="host"><titleInfo><title>Addiction</title></titleInfo><genre type="journal">journal</genre><identifier type="ISSN">0965-2140</identifier><identifier type="eISSN">1360-0443</identifier><identifier type="DOI">10.1111/(ISSN)1360-0443</identifier><identifier type="PublisherID">ADD</identifier><part><date>2006</date><detail type="volume"><caption>vol.</caption><number>101</number></detail><detail type="issue"><caption>no.</caption><number>9</number></detail><extent unit="pages"><start>1347</start><end>1351</end><total>5</total></extent></part></relatedItem><identifier type="istex">FF9CD93E8CB3CA280F1D191D78F26423A34E2C62</identifier><identifier type="DOI">10.1111/j.1360-0443.2006.01521.x</identifier><identifier type="ArticleID">ADD1521</identifier><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>Blackwell Publishing Ltd</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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