EXCESSIVE ORAL AMPHETAMINE USE AS A POSSIBLE CAUSE OF RENAL AND SPLANCHNIC ARTERIAL ANEURYSMS - A REPORT OF 2 CASES

Intronduction: Multiple visceral aneurysms are uncommon and usually re sult from connective tissue diseases, systemic arteritis, or mycotic l esions. An association between multiple visceral aneurysms and excessi ve oral amphetamine use has not been reported. Methods: The clinical f eatures of 2 patients at the University of Michigan Medical Center for treatment of multiple visceral aneurysms and amphetamine use were rev iewed. Results: The patients had histories of excessive oral amphetami ne use that ranged from 50 mg daily for 22 years to 200 mg daily for 2 years. No evidence was seen of systemic arteritis, connective tissue disorder, or an infectious process that may have caused the aneurysms. The arteriograms documented multiple splanchnic and renal artery aneu rysms that involved both the large and the small arteries. The aneurys ms of 1 patient were managed conservatively, and the patient has not h ad any clinical sequelae of the aneurysms during 14 years of follow-up . The second patient had hematobilia from a ruptured hepatic artery an eurysm that was treated with transcatheter embolic occlusion of the bl eeding vessel. The patient had no recurrent gastrointestinal problems and continued to use amphetamines until his death from a cerebrovascul ar accident 6 years later. Conclusion: A possible association between excessive oral amphetamine use and multiple visceral aneurysms is repo rted for 2 patients in whom other risk factors were absent. The potent ial for chronic oral amphetamine use to cause multiple visceral aneury sms is an ill-defined but not unexpected complication of this substanc e that is known to contribute to arterial hypertension and to produce a form of necrotizing arteritis.