Opana-ER used the wrong way: intravenous abuse leading to microangiopathic hemolysis and a TTP-like syndrome

Abstract

![Figure][1] A 23-year-old white woman with a history of intravenous drug abuse presented to the emergency department with decreased level of consciousness, chest discomfort, and shortness of breath. Blood work showed anemia (hemoglobin, 7.6 g/dL), thrombocytopenia (platelet count, 69 000