Cocaine-induced midline destructive lesions
Prolonged cocaine inhalation can cause destruction of nasal mucosa and ethmoid sinuses and palate perforation, thus inducing cocaine-induced midline destructive lesions (CIMDL) that affect only a limited number of predisposed patients. CIMDL are an autoimmune necrotizing inflammatory phenomenon a...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Sestre Milosrdnice University hospital, Institute of Clinical Medical Research
2024-01-01
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| Series: | Acta Clinica Croatica |
| Subjects: | |
| Online Access: | https://hrcak.srce.hr/file/474342 |
| Summary: | Prolonged cocaine inhalation can cause destruction of nasal mucosa and ethmoid
sinuses and palate perforation, thus inducing cocaine-induced midline destructive lesions (CIMDL)
that affect only a limited number of predisposed patients. CIMDL are an autoimmune necrotizing
inflammatory phenomenon associated with the presence of atypical antineutrophil cytoplasmic
antibody (ANCA). Patients complain of epistaxis, nasal obstruction, hyposmia, sinus infections, and
facial pain. Protocol for the CIMDL diagnosis includes medical history, clinical examination, magnetic
resonance imaging, laboratory tests, immunology and serology tests, and chest x-ray. A 68-year-old
man presented with a brain extension mimicking an ischemic-like lesion with surrounding edema.
A diagnosis of CIMDL was made in the light of the patient’s medical history, imaging studies, and
laboratory testing including pANCA positivity which seems to promote disease phenotype. |
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| ISSN: | 0353-9466 1333-9451 |