Cocaine and ANCA associated vasculitis-like syndromes - A case series

We analysed the spectrum of clinical manifestations of cocaine associated pseudovasculitis.

Clinical, serological, radiological and histological features of 14 patients with cocaine pseudovasculitis syndromes were included.

Twelve patients had significant sinus thickening or erosive disease. Other multi-system manifestations included vasculitic rashes, pulmonary lesions and peripheral neuropathy. All patients had positive ANCA titres at presentation. All patients were managed with corticosteroids +/- methotrexate and co-trimoxazole, 2 patients received cyclophosphamide.

Advanced erosive nasal septal defects and atypical ANCA patterns are suggestive of cocaine induced pseudovasculitis. Complete drug cessation may negate the need for exposure to potent immunosuppressive agents.