Clinical findings:
(1) dyspnea
(2) abnormal pulmonary function tests
(3) history of cocaine abuse, typically crack cocaine
(4) reversal or improvement on discontinuation of cocaine abuse
Radiographic findings:
(1) bilateral, diffuse interstitial pulmonary infiltrates
(2) bilateral hilar lymphadenopathy
Biopsy findings:
(1) noncaseating granulomas in lung and lymph nodes
(2) negative stains for acid fast bacilli and fungi
(3) The granulomas may show polarizable material.
Laboratory findings:
(1) elevated serum angiotensin converting enzyme (ACE; an elevation may occur in any granulomatous disorder)
(2) cytoplasmic anti-neutrophil cytoplasmic antibody (c-ANCA) may be positive
(3) cultures for mycobacteria and fungi are negative
