Pulmonary hypertension and foreign body granulomas in intravenous drug abusers. Documentation by cardiac catheterization and lung biopsy.

In this report we confirm the presence of pulmonary hypertension by cardiac catheterization in four intravenous drug abusers with biopsy-documented foreign body granulomas in the pulmonary vessels and interstitium. Each patient had a history of intravenous injections of alpha-sympathomimetic agents obtained from nasal inhalers. There agents may have contributed to the disease by constricting small vessels when simultaneously injected foreign bodies were passing through the vasculature of the lung. The severity of the pulmonary hypertension correlated well with the decrease in single breath diffusing capacity in each case. Pulmonary hypertension may contribute significantly to the increased morbidity and mortality observed in intravenous drug users.