Sujith Subesinghe1, Sander van Leuven2, Leena Yalakki3, Shirish Sangle3, David D'Cruz4. 1. Academic Department of Rheumatology, King's College London, UK; Department of Rheumatology and Lupus, Guy's and St. Thomas' NHS Foundation Trust, London, UK. 2. Department of Rheumatology and Lupus, Guy's and St. Thomas' NHS Foundation Trust, London, UK; Department of Rheumatology, Radboud University Medical Centre, Nijmegen, Netherlands. 3. Department of Rheumatology and Lupus, Guy's and St. Thomas' NHS Foundation Trust, London, UK. 4. Department of Rheumatology and Lupus, Guy's and St. Thomas' NHS Foundation Trust, London, UK. Electronic address: david.d'cruz@kcl.ac.uk.
Abstract
OBJECTIVES: We analysed the spectrum of clinical manifestations of cocaine associated pseudovasculitis. METHODS: Clinical, serological, radiological and histological features of 14 patients with cocaine pseudovasculitis syndromes were included. RESULTS: Twelve patients had significant sinus thickening or erosive disease. Other multi-system manifestations included vasculitic rashes, pulmonary lesions and peripheral neuropathy. All patients had positive ANCA titres at presentation. All patients were managed with corticosteroids +/- methotrexate and co-trimoxazole, 2 patients received cyclophosphamide. CONCLUSIONS: Advanced erosive nasal septal defects and atypical ANCA patterns are suggestive of cocaine induced pseudovasculitis. Complete drug cessation may negate the need for exposure to potent immunosuppressive agents.
OBJECTIVES: We analysed the spectrum of clinical manifestations of cocaine associated pseudovasculitis. METHODS: Clinical, serological, radiological and histological features of 14 patients with cocaine pseudovasculitis syndromes were included. RESULTS: Twelve patients had significant sinus thickening or erosive disease. Other multi-system manifestations included vasculitic rashes, pulmonary lesions and peripheral neuropathy. All patients had positive ANCA titres at presentation. All patients were managed with corticosteroids +/- methotrexate and co-trimoxazole, 2 patients received cyclophosphamide. CONCLUSIONS: Advanced erosive nasal septal defects and atypical ANCA patterns are suggestive of cocaine induced pseudovasculitis. Complete drug cessation may negate the need for exposure to potent immunosuppressive agents.
Authors: Letizia Nitro; Carlotta Pipolo; Gian Luca Fadda; Giovanni Felisati; Alberto Maria Saibene; Fabiana Allevi; Mario Borgione; Giovanni Cavallo Journal: Eur Arch Otorhinolaryngol Date: 2022-02-09 Impact factor: 3.236
Authors: Monica M Diaz; John R Keltner; Alan N Simmons; Donald Franklin; Raeanne C Moore; David Clifford; Ann C Collier; Benjamin B Gelman; Ph D Christina Marra; J Allen McCutchan; Susan Morgello; Ned Sacktor; Brookie Best; Christine Fennema Notestine; Sara Gianella Weibel; Igor Grant; Thomas D Marcotte; Florin Vaida; Scott Letendre; Robert Heaton; Ronald J Ellis Journal: Pain Med Date: 2021-08-06 Impact factor: 3.750