Case Studies involving Bilateral Lower Limb Lymphoedema following Pentazocine Abuse in Sickle Cell Disease Patients

Abstract

Background: Lymphoedema which results from lymphatic obstruction can cause significant morbidity in affected individuals. Pentazocine injection has several complications including skin ulceration, scaring and fibrous myopathy and these may predispose to lymphoedema. Sickle cell disease (SCD) being a condition characterized by chronic pain tends to provide a background for frequent pentazocine injection or abuse, and this could in turn be accompanied by other complications. Reports of lymphoedema as a remote complication of repeated pentazocine injection are scarce and efforts must be made to prevent this vicious sequel. This case series highlights Nigerian SCD patients who developed bilateral lower limb lymphoedema following prolonged self administration of pentazocine injection. Setting: University of Benin Teaching Hospital, Benin City, Edo state. Subjects: Three cases of bilateral lower limb lymphoedema following pentazocine abuse in SCD patients. Clinical Findings: The patients all had prolonged self injection of pentazocine. Examination revealed bilateral lower limb lymphoedema. The diagnoses were made largely from clinical evidence and multidisciplinary management instituted for the cases. Conclusion: Preventive and proactive measures must be taken to forestall this apparently increasing complication of pentazocine injection. Such intervention will include minimizing the use of parenteral pentazocine. A high index of suspicion for intramuscular pentazocine abuse is required when dealing with young SCD patients who develop lymphoedema of the extremities.