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Thrombotic microangiopathy (TMA) is a devastating disorder that affects vessels in the kidney, brain, and other organs and is often associated with a fatal outcome. TMA has been reported in individuals infusing extended-release oxymorphone tablets (Opana ER) intravenously; this preparation contains high-molecular-weight polyethylene oxide (PEO) and other inert ingredients (PEO+).
To determine whether the opioid itself or the inert ingredients were responsible for TMA, investigators studied three patients with intravenous Opana abuse and infused guinea pigs with varying doses of PEO+.
The patients had chest pain and dyspnea; one had visual impairment with diffuse occlusive disease of the retinal arterioles; two patients were in acute renal fai…