| Cutaneous vasculopathy associated with cocaine use. | |
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MedLine Citation:
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PMID: 21523921 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Cocaine is known to cause thrombotic complications. Its use has also been associated with a variety of rheumatologic manifestations, most notably cutaneous vasculopathy. We report clinical features and laboratory findings of cocaine-related cutaneous vasculopathy. METHODS: Here we describe 8 patients with cocaine-related cutaneous vasculopathy. RESULTS: Our patients most commonly presented with purpuric lesions and ulcers with areas of skin necrosis. Extracutaneous features included fatigue and arthritis in most patients, as well as weight loss in 3 patients, pneumonia in 3, diffuse reactive lymphadenopathy in 1, and acute upper airway obstruction in 2. Laboratory abnormalities included elevated inflammatory markers and positive perinuclear antineutrophil cytoplasmic antibodies (ANCAs) in all patients, and antimyeloperoxidase antibodies in 7 of 8 patients. Cytoplasmic ANCA was positive in 5 of 8, equivocal in 2 of 8, and negative in 1 of 8 patients. Anti-proteinase 3 antibodies were found in 6 of 8 patients. Six of 8 patients had positive antinuclear antibodies and 5 of 8 had positive anti-double-stranded DNA antibodies (4 of 5 were at low titers). Two patients previously thought to have systemic lupus erythematosus had low complement levels. Lupus anticoagulant was positive in 3 of 8 and equivocal in 5 of 8. Anticardiolipin IgG was positive in 1 of 8 and IgM was positive in 6 of 8; β(2) -glycoprotein I IgM was positive in 2 of 8. Cold agglutinins were strongly positive in 6 of 6 patients in whom they were measured. Skin disease improved in 3 patients who appeared to have stopped using cocaine. It was chronic and progressive in 4 patients who continued to use cocaine, 2 of whom died presumably due to multidrug overdose. CONCLUSION: This report outlines clinical features and distinctive laboratory findings that, when present in the right clinical setting, should prompt consideration of cocaine-related cutaneous vasculopathy. |
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Authors:
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Nataliya Milman; C Douglas Smith |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Arthritis care & research Volume: 63 ISSN: 2151-4658 ISO Abbreviation: Arthritis Care Res (Hoboken) Publication Date: 2011 Aug |
Date Detail:
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Created Date: 2011-08-02 Completed Date: 2011-10-03 Revised Date: 2011-12-09 |
Medline Journal Info:
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Nlm Unique ID: 101518086 Medline TA: Arthritis Care Res (Hoboken) Country: United States |
Other Details:
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Languages: eng Pagination: 1195-202 Citation Subset: IM |
Copyright Information:
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Copyright © 2011 by the American College of Rheumatology. |
Affiliation:
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The Arthritis Centre, Ottawa Hospital, and University of Ottawa, 1967 Riverside Drive, Ottawa, Ontario, Canada. nmilman@ottawahospital.on.ca |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Anemia, Hemolytic, Autoimmune / blood*, complications, pathology Antibodies, Antinuclear / blood* Antibodies, Antiphospholipid / blood* Cocaine-Related Disorders / blood, complications*, immunology Female Humans Male Middle Aged Purpura / etiology, immunology, pathology Skin Diseases, Vascular / blood, etiology*, immunology, pathology |
| Chemical | |
Reg. No./Substance:
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0/Antibodies, Antinuclear; 0/Antibodies, Antiphospholipid |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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