Cocaine- and Levamisole-Induced Vasculitis: Defining the Spectrum of Autoimmune Manifestations

被引:1
|
作者
Iorio, Luca [1 ]
Davanzo, Federica [1 ]
Cazzador, Diego [2 ]
Codirenzi, Marta [1 ]
Fiorin, Eleonora [1 ]
Zanatta, Elisabetta [1 ,3 ]
Nicolai, Piero [2 ]
Doria, Andrea [1 ]
Padoan, Roberto [1 ]
机构
[1] Univ Padua, Dept Med DIMED, Rheumatol Unit, I-35128 Padua, Italy
[2] Univ Padua, Dept Neurosci DNS, Otolaryngol Sect, I-35128 Padua, Italy
[3] Univ Padua, Dept Cardiac Thorac Vasc Sci & Publ Hlth, I-35128 Padua, Italy
关键词
vasculitis; cocaine; levamisole; antineutrophil cytoplasmic autoantibody; ANCA; cocaine-induced midline destructive lesion; CIMDL; cocaine-induced vasculitis; CIV; levamisole-adulterated cocaine; LAC vasculopathy/vasculitis; MIDLINE DESTRUCTIVE LESIONS; ANTINEUTROPHIL CYTOPLASMIC ANTIBODIES; ANCA-ASSOCIATED VASCULITIS; OSTEOCARTILAGINOUS NECROSIS; NECROTIZING VASCULITIS; SINONASAL INVOLVEMENT; INDUCED VASCULOPATHY; NEUTROPHIL ELASTASE; PALATE PERFORATION; RETIFORM PURPURA;
D O I
10.3390/jcm13175116
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Drug-induced or associated vasculitis is a prevalent form of vasculitis that resembles primary idiopathic antineutrophil cytoplasmic autoantibody (ANCA) vasculitis (AAV). Cocaine is a diffuse psychostimulant drug and levamisole is a synthetic compound used to cut cocaine. Their abuse may result in a spectrum of autoimmune manifestations which could be categorized into three overlapping clinical pictures: cocaine-induced midline destructive lesion (CIMDL), levamisole-adulterated cocaine (LAC) vasculopathy/vasculitis, and cocaine-induced vasculitis (CIV). The mechanisms by which cocaine use leads to disorders resembling AAV are not well understood. Cocaine can cause autoimmune manifestations ranging from localized nasal lesions to systemic diseases, with neutrophils playing a key role through NETosis and ANCA development, which exacerbates immune responses and tissue damage. Diagnosing and treating these conditions becomes challenging when cocaine and levamisole abuse is not suspected, due to the differences and overlaps in clinical, diagnostic, therapeutic, and prognostic aspects compared to primary idiopathic vasculitides.
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页数:19
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