A person who abuses cocaine or amphetamines may develop a vasculitis that persists as long as the person continues to abuse drugs. Drug abuse should be suspected in a patient with a vasculitis that does not quite fit the usual pattern.
Clinical features:
(1) presence of either localized or systemic vasculitis
(2) history of current cocaine or amphetamine abuse
(3) disappearance of the vasculitis on discontinuation of drug abuse
Laboratory findings:
(1) elevated ESR
(2) positive ANCA, including c-ANCA
Distribution of Vasculitis
Effect
necrotizing granulomatous vasculitis of the midface
midline destructive lesions that mimic Wegener's granulomatosis, with
cerebral vasculitis
vasospasm with ischemic stroke
rash and arthritis with IgA deposits
mimic Schoenlein-Henoch purpura
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