World's 1st case of brain disease from fentanyl inhalation: Case study

Portland-based Oregon Health & Science University documented the world's first known case of brain disease from fentanyl inhalation.

The case study, published in the April issue of BMJ Case Reports, outlines the case of a 47-year-old man who was brought to the emergency department on Feb. 25, 2023. He had collapsed in his hotel room where he was staying during a business trip.

OHSU clinicians were able to determine his diagnosis to be toxic leukoencephalopathy caused by fentanyl inhalation. He was diagnosed by magnetic resonance imaging and a nonstandard drug test, which revealed the presence of fentanyl. Inhaled fentanyl caused large sections of white matter in the patient's brain to become inflamed to the point of losing consciousness and risking loss of brain function.

Cases caused by inhaling heroin have been documented before, but OHSU said in an April 29 news release they believe this is the first patient to be documented with inhalation of illicit fentanyl — though the report noted that there are likely other cases that were not recognized.

The patient recovered after 26 days in the hospital and a stay in a skilled nursing facility. He has returned home to Seattle and is back at work and with his family, according to the report.

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