A patient who abuses cocaine may present with all of the features of pulmonary sarcoidosis.
(2) abnormal pulmonary function tests
(3) history of cocaine abuse, typically crack cocaine
(4) reversal or improvement on discontinuation of cocaine abuse
(1) bilateral, diffuse interstitial pulmonary infiltrates
(2) bilateral hilar lymphadenopathy
(1) noncaseating granulomas in lung and lymph nodes
(2) negative stains for acid fast bacilli and fungi
(3) The granulomas may show polarizable material.
(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
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Specialty: Pulmonology, Immunology/Rheumatology