{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T17:07:29Z","timestamp":1767373649365},"reference-count":5,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2014,4,15]],"date-time":"2014-04-15T00:00:00Z","timestamp":1397520000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2014,7]]},"abstract":"<jats:p>In January 2013, the Centers for Disease Control and Prevention reported an illness associated with intravenous (IV) abuse of oral Opana ER (oxymorphone) in Tennessee. The clinical presentation of this syndrome was reported to resemble that of thrombotic thrombocytopenic purpura in the 15 patients reported; 12 were treated with plasma exchange. We report a similar case series of 15 patients with 18 episodes of thrombotic microangiopathy associated with recent IV abuse of oral Opana ER. In our series, we demonstrate that therapeutic plasma exchange is unnecessary; supportive care and treatment of underlying infections and renal dysfunction (without use of plasma exchange) resulted in clinical improvement in all patients. Thus, it appears that plasma exchange with associated costs and risks can be safely omitted in patients with thrombotic microangiopathy resulting from IV abuse of oral Opana ER. Am. J. Hematol. 89:695\u2013697, 2014. \u00a9 2014 Wiley Periodicals, Inc.<\/jats:p>","DOI":"10.1002\/ajh.23720","type":"journal-article","created":{"date-parts":[[2014,3,25]],"date-time":"2014-03-25T09:36:24Z","timestamp":1395740184000},"page":"695-697","source":"Crossref","is-referenced-by-count":21,"title":["Successful treatment of intravenously abused oral Opana ER\u2010induced thrombotic microangiopathy without plasma exchange"],"prefix":"10.1002","volume":"89","author":[{"given":"Peter John","family":"Miller","sequence":"first","affiliation":[{"name":"Department of Medicine Section on Hematology and Oncology, Wake Forest School of Medicine Winston\u2010Salem North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew Matthew","family":"Farland","sequence":"additional","affiliation":[{"name":"Department of Medicine Section on Hematology and Oncology, Wake Forest School of Medicine Winston\u2010Salem North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary Ann","family":"Knovich","sequence":"additional","affiliation":[{"name":"Department of Medicine Section on Hematology and Oncology, Wake Forest School of Medicine Winston\u2010Salem North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katharine Marie","family":"Batt","sequence":"additional","affiliation":[{"name":"Department of Medicine Section on Hematology and Oncology, Wake Forest School of Medicine Winston\u2010Salem North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Owen","sequence":"additional","affiliation":[{"name":"Department of Medicine Section on Hematology and Oncology, Wake Forest School of Medicine Winston\u2010Salem North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,4,15]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"1","article-title":"Thrombotic thrombocytopenic purpura (TTP)\u2010like illness associated with intravenous Opana ER abuse\u2013Tennessee, 2012","volume":"62","author":"(CDC) CfDCaP","year":"2013","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2013-05-503904"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0032-1328886"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.21220"},{"key":"e_1_2_6_6_1","doi-asserted-by":"crossref","first-page":"2322","DOI":"10.1182\/blood.V122.21.2322.2322","article-title":"Plasma exchange is not necessary for the treatment of microangiopathic hemolytic anemia due to intravenous Opana abuse","volume":"122","author":"Miller PJ","year":"2013","journal-title":"Blood"}],"container-title":["American Journal of Hematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fajh.23720","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ajh.23720","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,6]],"date-time":"2023-10-06T09:26:04Z","timestamp":1696584364000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ajh.23720"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,4,15]]},"references-count":5,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2014,7]]}},"alternative-id":["10.1002\/ajh.23720"],"URL":"https:\/\/doi.org\/10.1002\/ajh.23720","archive":["Portico"],"relation":{},"ISSN":["0361-8609","1096-8652"],"issn-type":[{"value":"0361-8609","type":"print"},{"value":"1096-8652","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,4,15]]}}}