Cerebral Vasculitis and Hemorrhage in an Adolescent Taking Diet Pills Containing Phenylpropanolamine: Case Report and Review of Literature

Phenylpropanolamine is consumed by millions of persons annually and is sold in varying dosages and combinations for different ailments. Adolescents are an especially susceptible group influenced by its action as an anorexiant. During the past 6 years, several cases have been reported of patients in whom intracerebral hemorrhage developed, with and without concomitant angiographic evidence of vasculitis, after taking phenylpropanolamine. In this report, the 11th documented case of phenylpropanolamine-associated intracerebral hemorrhage with vasculitis is described. This is the first case in an adolescent following the ingestion of an overdose of diet-aid pills. Cases of intracerebral hemorrhage with vasculitis have also been described in users and abusers of amphetamine, methamphetamine, and ephedrine, all sympathomimetics with chemical structures similar to that of phenylpropanolamine. This report should alert pediatricians to the potential use by their patients of nonprescription medications containing phenylpropanolamine whenever unexplained acute cerebral symptoms are present.