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Review
. 2016 Oct 31;7(4):e0036.
doi: 10.5041/RMMJ.10263.

Cocaine-Induced Vasculitis

Mark Berman  1   2 , Daphna Paran  1   2 , Ori Elkayam  1   2
Affiliations
Review

Cocaine-Induced Vasculitis

Mark Berman et al. Rambam Maimonides Med J. .

Abstract

The use of cocaine continues to grow worldwide. One of the possible side-effects of cocaine is vasculitis. Two distinct vasculitic syndromes have been described due to cocaine. One is cocaine-induced midline destructive lesion, secondary to a direct vasoconstrictor effect of cocaine, inducing ischemic necrosis of the septal cartilage and perforation of the nasal septum, mimicking findings of granulomatosis with polyangiitis in the upper airways. The other is ANCA-associated vasculitis, attributed to the levamisole component that contaminates about 70% of the cocaine. This type of vasculitis may be myeloperoxidase (MPO) and proteinase 3 (PR3) positive, and its main manifestations are typical cutaneous findings, arthralgia, otolaryngologic involvement, and agranulocytosis. A high degree of suspicion and awareness is needed in order properly to diagnose and treat these patients.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

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References

    1. UNODC. World Drug Report 2013. (United Nations publication, Sales No. E.13.XI.6)
    1. Riezzo I, Fiore C, De Carlo D, et al. Side effects of cocaine abuse: multiorgan toxicity and pathological consequences. Curr Med Chem. 2012;19:5624–46. https://doi.org/10.2174/092986712803988893. - DOI - PubMed
    1. Gross RL, Brucker J, Bahce-Altuntas A, et al. A novel cutaneous vasculitis syndrome induced by levamisole-contaminated cocaine. Clin Rheumatol. 2011;30:1385–92. https://doi.org/10.1007/s10067-011-1805-3. - DOI - PubMed
    1. Chang A, Osterloh J, Thomas J. Levamisole: a dangerous new cocaine adulterant. Clin Pharmacol Ther. 2010;88:408–11. https://doi.org/10.1038/clpt.2010.156. - DOI - PubMed
    1. Daggett RB, Haghighi P, Terkeltaub RA. Nasal cocaine abuse causing an aggressive midline intranasal and pharyngeal destructive process mimicking midline reticulosis and limited Wegener’s granulomatosis. J Rheumatol. 1990;17:838–40. - PubMed