Cocaine use and its rheumatic manifestations: a case report and discussion

Bhinder, Sumeet; Majithia, Vikas

doi:10.1007/s10067-006-0327-x

Cited by 30 publications

(23 citation statements)

References 13 publications

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“…Mild leukocytoclasis has been described in a patient diagnosed with cocaine-associated vasculopathy previously (2). Although the term cocaine-related cutaneous vasculitis may be more appropriate in this setting, we have included this patient in this series because the similarity of clinical features and laboratory findings to other patients described here suggests a common pathologic process.…”

Section: Discussionmentioning

confidence: 97%

“…Case reports describe cocaine use in association with a wide range of rheumatologic complications (2). Due to the difficulties inherent in studying the population of cocaine users, precise epidemiologic data such as prevalence or incidence of the abovementioned rheumatologic conditions in cocaine users are not known.…”

Section: Discussionmentioning

confidence: 99%

“…A variety of rheumatologic manifestations have been described in association with cocaine use, including different connective tissue diseases, vasculitides (2), and cocaine-induced midline destructive lesions (CIMDL), a condition that frequently mimics granulomatosis with polyangiitis (Wegener's) (GPA) (3)(4)(5). In addition, there are reports of cocaine in association with skin vasculopathy, which usually has the clinical appearance of cutaneous vasculitis with the absence of significant vascular inflammation on biopsy (2,6).…”

Section: Introductionmentioning

confidence: 99%

“…In addition, there are reports of cocaine in association with skin vasculopathy, which usually has the clinical appearance of cutaneous vasculitis with the absence of significant vascular inflammation on biopsy (2,6).…”

Section: Introductionmentioning

confidence: 99%

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Cutaneous vasculopathy associated with cocaine use

Milman

Smith

2011

Arthritis Care & Research

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Cutaneous vasculopathy associated with cocaine use

Milman

Smith

2011

Arthritis Care & Research

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“…After these symptoms had been present for several weeks, the patient established care with a primary care physician. At his first appointment his erythrocyte sedimentation rate (ESR) was 42 mm/hour (normal range [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. An assay for antinuclear antibodies (ANA) was positive at a titer of 1:160 (speckled), but antibodies to double-stranded DNA and to extractable nuclear antigens (Ro, La, Sm, and RNP) were negative.…”

mentioning

confidence: 99%

A 36‐year‐old man with paresthesias and a headache

Castelino

Wasfy

Collier

2008

Arthritis & Rheumatism

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History of the present illnessA 36-year-old man with a history of non-Hodgkin's lymphoma was admitted to the hospital with paresthesias and a headache. His paresthesias began 5 months prior to admission, when he developed left leg numbness and pain, accompanied by an erythematous rash that he described as "splotchy." The rash appeared initially on the patient's left leg, but then expanded to include his torso and upper extremities. The rash, numbness, and pain all resolved without intervention after 1 week. Three months prior to admission, he experienced recurrent numbness in the left leg that again resolved spontaneously after several days.Two months prior to admission, the patient's symptoms intensified. He developed bilateral numbness and tingling, first in both feet and then in both hands. He noted that grasping objects with his hands caused a burning sensation in his palms, and he experienced pain and swelling in his left foot and ankle. After these symptoms had been present for several weeks, the patient established care with a primary care physician. At his first appointment his erythrocyte sedimentation rate (ESR) was 42 mm/hour (normal range 1-20). An assay for antinuclear antibodies (ANA) was positive at a titer of 1:160 (speckled), but antibodies to double-stranded DNA and to extractable nuclear antigens (Ro, La, Sm, and RNP) were negative. The laboratory results are shown in Table 1.One month before admission, the patient developed "unbearable" pain in his feet and noted that his socks felt too tight. He reported tingling in his hands, nausea, and daily emesis. The patient was referred for nerve conduction velocity and electromyography of the lower and upper extremities. These investigations revealed a symmetric sensory polyneuropathy that predominantly involved the lower extremities. The patient was prescribed gabapentin (200 mg 3 times daily), but his symptoms persisted. Three days prior to admission, the patient developed a severe occipital headache that did not remit despite use of ibuprofen (600 mg 3 times daily).On the morning of admission, the patient presented to his primary care doctor reporting a severe headache (rated as 10/10), profound fatigue, and numbness, pain, and weakness in both feet. His blood pressure was 168/119 mm Hg in the right arm and 175/123 mm Hg in the left arm. He was referred to the emergency department for hypertensive urgency. Past medical historyThe patient's non-Hodgkin's lymphoma was diagnosed at age 16 years. He had been treated with a standard chemotherapy regimen for 6 cycles (CHOP: cyclophosphamide, hydroxydaunomycin [doxorubicin], vincristine, and prednisone). This treatment was presumed to have resulted in a cure. The patient was also diagnosed with iron deficiency anemia several years before admission. An esophagogastroduodenoscopy at that time was normal. Family and social historyThe patient's family history was remarkable for the fact that his father had multiple strokes before the age of 40 years. In addition, the patient reported many relatives on both p...

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