Misdiagnosis Of Cocaine Induced Nasal Damage As An Innocuous Disease Could Be Life-Threatening, Reveals Study On Granulomatosis With Polyangiitis
Medical News : Cocaine - Granulomatosis With Polyangiitis Apr 04, 2023 2 months ago
A shocking new study has found that many patients diagnosed with granulomatosis with polyangiitis (GPA), a nasal disease causing inflammation of blood vessels, may actually be suffering from nasal damage due to cocaine use.
Pic Credit : Getty Image
The study by researchers from University Hospitals Birmingham NHS Foundation Trust-UK, University College London Hospital-UK and Royal Free Hospital, London-UK had revealed that cocaine-induced midline destructive lesions and other vascular problems can mimic GPA symptoms, making accurate diagnosis difficult for doctors.
Cocaine is the second-most commonly abused drug in the United Kingdom, with 2.6% of the population between ages 16 and 59 years old using it. In the United States, 4.8 million people (1.7% of those over age 12) report using cocaine in the past year. The drug can cause significant health problems, including damage to the nasal cavity, throat, lungs, and kidneys.
Cocaine usage is very high among celebrities, entertainers, tech and business millionaires, models, social escorts and also politicians these days especially in countries like the United States, United Kingdom, Canada, New Zealand, Ukraine, Germany France, Spain, Italy and even Thailand!
The study team reviewed patients who visited vasculitis clinics for treatment at Queen Elizabeth Hospital in Birmingham and at the Royal Free Hospital in London.
The researchers found that 86% of patients tested positive for cocaine use, even those who denied ever using it. Ten patients referred to vasculitis treatment centers had been previously given a diagnosis of GPA and given immunosuppressive drugs. Despite this treatment, they still had ongoing nasal problems.
The study team argue that doctors should test patients with destructive nasal lesions or isolated sino-nasal disease for cocaine before making a diagnosis of GPA. Immunosuppressive drugs are often ineffective if cocaine use persists and can increase the risk of significant adverse effects, including infection.
Co-author, Dr Aine Burns told Thailand Medical News
, "This is an important paper that has changed our practice. We now include urine samples for drugs of abuse in our initial investigations of patients with GPA and in those who appear not to be responding to treatment. Sadly, we have seen young people with life-changing disfigurement because of cocaine-induced granulomatosis with polyangiitis. A better understanding of this condition prevents us from potentially harming patients further by administering inappropriate, potentially toxic, and futile treatments."
With cocaine use on the rise globally, it is crucial for healthcare professionals and the public to be aware of the potential dangers and misdiagnosis of cocaine-induced nasal damage. This study serves as a wake-up call to prioritize cocaine screening for patients with nasal and sinus-related health issues. Early detection can prevent further harm and potentially save lives.
Details Of Study Abstract
The study aimed to investigate the effects of cocaine and cocaine mixed with levamisole, a medication used to treat parasitic infections in humans and a
nimals, on patients in the UK. The study focused on identifying the main symptoms and presentation of cocaine-induced vasculitis and providing evidence on the best practices for investigating and diagnosing the condition. Additionally, the study aimed to analyze the clinical outcomes of patients to better understand the optimal management of the condition.
The study was conducted retrospectively, analyzing patients who presented with cocaine-induced midline destructive lesions or vasculitis compatible with granulomatosis with polyangiitis (GPA) at two large tertiary vasculitis clinics between 2016 and 2021. The researchers identified 42 patients with destructive nasal lesions, with a median age of 41 years. Current cocaine use was prevalent, with 20 out of 23 samples testing positive for cocaine in routine urine toxicology tests. Shockingly, some patients who denied ever using cocaine were identified as using it based on urine toxicology analysis.
The study found a high incidence of septal perforation and oronasal fistula among patients, along with systemic manifestations that were less common. Moreover, only one patient had acute kidney injury. The study found that symptom remission required cocaine discontinuation, even when immunosuppression was administered. The ANCA pattern was not specific for cocaine-induced midline destructive lesions, and treatment should focus on cocaine cessation and conservative management in the absence of organ-threatening disease.
The study concludes that patients with destructive nasal lesions, especially young patients, should have urine toxicology tests performed for cocaine before diagnosing GPA and considering immunosuppressive therapy. With cocaine use on the rise, it is essential for healthcare professionals to be aware of the prevalence of cocaine-induced midline destructive lesions and the need for early detection to prevent further harm.
The study findings were published in peer reviewed journal: Rheumatology Advances in Practice.
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