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Pulmonary artery medial hypertrophy in cocaine users without foreign particle microembolization
R J Murray1, J E Smialek, M Golle
1Department of Medicine, University of Maryland School of Medicine and Hospital, Baltimore.
Chest
|November 1, 1989
Summary
Cocaine smoking is linked to lung issues. Autopsies revealed pulmonary artery medial hypertrophy and occult alveolar hemorrhage in cocaine users, suggesting significant pulmonary vascular changes.
Area of Science:
- Pulmonary Pathology
- Toxicology
- Cardiovascular Pathology
Background:
- Reduced diffusing capacity of the lungs for carbon monoxide (DCO) is observed in "free-base" cocaine smokers.
- Cocaine use can lead to various systemic and organ-specific toxicities.
Purpose of the Study:
- To investigate pulmonary histopathology in cocaine intoxication deaths.
- To identify potential causes for the observed reduction in DCO among cocaine smokers.
Main Methods:
- Review of pulmonary histopathology in 20 fatal cocaine intoxication cases.
- Examination for parenchymal or vascular abnormalities.
- Comparison with a matched control group.
Main Results:
- Pulmonary artery medial hypertrophy was found in 20% of cases, without evidence of foreign particle microembolization.
- Hemosiderin-laden macrophages, indicative of alveolar hemorrhage, were present in 35% of cases.
- These abnormalities were absent in the control group.
Conclusions:
- Cocaine use is associated with pulmonary artery medial hypertrophy, even without foreign particle microembolization.
- Occult alveolar hemorrhage is more frequent in cocaine users than previously recognized.
- The mechanisms underlying these cocaine-induced vascular changes require further investigation.