Cocaine-induced midline destructive lesions

Prolonged cocaine inhalation can cause destruction of nasal mucosa and ethmoid sinuses and palate perforation, thus inducing cocaine-induced midline destructive lesions (CIMDL) that affect only a limited number of predisposed patients. CIMDL are an autoimmune necrotizing inflammatory phenomenon a...

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Main Authors: Hanna Pašić, Branka Vidrih, Iva Šarac, Nina Rotim, Ana Hrkać Pustahija, Branko Malojčić, Ivana Karla Franić, Ivona Radmanović, Maja Živković, Stjepan Jurić, Jelena Šarić-Jurić, Marija Bošnjak Pašić
Format: Article
Language:English
Published: Sestre Milosrdnice University hospital, Institute of Clinical Medical Research 2024-01-01
Series:Acta Clinica Croatica
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Online Access:https://hrcak.srce.hr/file/474342
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author Hanna Pašić
Branka Vidrih
Iva Šarac
Nina Rotim
Ana Hrkać Pustahija
Branko Malojčić
Ivana Karla Franić
Ivona Radmanović
Maja Živković
Stjepan Jurić
Jelena Šarić-Jurić
Marija Bošnjak Pašić
author_facet Hanna Pašić
Branka Vidrih
Iva Šarac
Nina Rotim
Ana Hrkać Pustahija
Branko Malojčić
Ivana Karla Franić
Ivona Radmanović
Maja Živković
Stjepan Jurić
Jelena Šarić-Jurić
Marija Bošnjak Pašić
author_sort Hanna Pašić
collection DOAJ
description Prolonged cocaine inhalation can cause destruction of nasal mucosa and ethmoid sinuses and palate perforation, thus inducing cocaine-induced midline destructive lesions (CIMDL) that affect only a limited number of predisposed patients. CIMDL are an autoimmune necrotizing inflammatory phenomenon associated with the presence of atypical antineutrophil cytoplasmic antibody (ANCA). Patients complain of epistaxis, nasal obstruction, hyposmia, sinus infections, and facial pain. Protocol for the CIMDL diagnosis includes medical history, clinical examination, magnetic resonance imaging, laboratory tests, immunology and serology tests, and chest x-ray. A 68-year-old man presented with a brain extension mimicking an ischemic-like lesion with surrounding edema. A diagnosis of CIMDL was made in the light of the patient’s medical history, imaging studies, and laboratory testing including pANCA positivity which seems to promote disease phenotype.
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publishDate 2024-01-01
publisher Sestre Milosrdnice University hospital, Institute of Clinical Medical Research
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spelling doaj-art-1f3e77c9e5544bd8b19c0d21e5c9d6b12025-08-20T03:11:43ZengSestre Milosrdnice University hospital, Institute of Clinical Medical ResearchActa Clinica Croatica0353-94661333-94512024-01-0163.243143510.20471/acc.2024.63.02.21Cocaine-induced midline destructive lesionsHanna Pašić0Branka Vidrih1Iva Šarac2Nina Rotim3Ana Hrkać Pustahija4Branko Malojčić5Ivana Karla Franić6Ivona Radmanović7Maja Živković8Stjepan Jurić9Jelena Šarić-Jurić10Marija Bošnjak Pašić11Department of Psychiatry, Sestre milosrdnice University Hospital Center, Zagreb, CroatiaDepartment of Psychiatry, Sestre milosrdnice University Hospital Center, Zagreb, Croatia; School of Medicine, Catholic University of Croatia, Zagreb, CroatiaSchool of Medicine, University of Zagreb, Zagreb, CroatiaSchool of Medicine, University of Zagreb, Zagreb, CroatiaDepartment of Neuroradiology, Zagreb University Hospital Center, Zagreb, CroatiaSchool of Medicine, University of Zagreb, Zagreb, Croatia; Department of Neurology, Zagreb University Hospital Center, Zagreb, CroatiaDepartment of Neurology, Zagreb University Hospital Center, Zagreb, CroatiaDepartment of Neurology, Sisak General Hospital, Sisak, CroatiaSchool of Medicine, University of Zagreb, Zagreb, Croatia; Department of Psychiatry, Zagreb University Hospital Center, Zagreb, CroatiaDepartment of Neurology, Osijek University Hospital Center, Osijek, Croatia; Faculty of Medicine, Josip Juraj Strossmayer University, Osijek, CroatiaDepartment of Neurology, Osijek University Hospital Center, Osijek, Croatia; Faculty of Medicine, Josip Juraj Strossmayer University, Osijek, CroatiaDepartment of Neurology, Zagreb University Hospital Center, Zagreb, Croatia; Faculty of Medicine, Josip Juraj Strossmayer University, Osijek, CroatiaProlonged cocaine inhalation can cause destruction of nasal mucosa and ethmoid sinuses and palate perforation, thus inducing cocaine-induced midline destructive lesions (CIMDL) that affect only a limited number of predisposed patients. CIMDL are an autoimmune necrotizing inflammatory phenomenon associated with the presence of atypical antineutrophil cytoplasmic antibody (ANCA). Patients complain of epistaxis, nasal obstruction, hyposmia, sinus infections, and facial pain. Protocol for the CIMDL diagnosis includes medical history, clinical examination, magnetic resonance imaging, laboratory tests, immunology and serology tests, and chest x-ray. A 68-year-old man presented with a brain extension mimicking an ischemic-like lesion with surrounding edema. A diagnosis of CIMDL was made in the light of the patient’s medical history, imaging studies, and laboratory testing including pANCA positivity which seems to promote disease phenotype.https://hrcak.srce.hr/file/474342CocaineAnti-neutrophil cytoplasmic antibodiesCocaine-induced midline destructive lesions
spellingShingle Hanna Pašić
Branka Vidrih
Iva Šarac
Nina Rotim
Ana Hrkać Pustahija
Branko Malojčić
Ivana Karla Franić
Ivona Radmanović
Maja Živković
Stjepan Jurić
Jelena Šarić-Jurić
Marija Bošnjak Pašić
Cocaine-induced midline destructive lesions
Acta Clinica Croatica
Cocaine
Anti-neutrophil cytoplasmic antibodies
Cocaine-induced midline destructive lesions
title Cocaine-induced midline destructive lesions
title_full Cocaine-induced midline destructive lesions
title_fullStr Cocaine-induced midline destructive lesions
title_full_unstemmed Cocaine-induced midline destructive lesions
title_short Cocaine-induced midline destructive lesions
title_sort cocaine induced midline destructive lesions
topic Cocaine
Anti-neutrophil cytoplasmic antibodies
Cocaine-induced midline destructive lesions
url https://hrcak.srce.hr/file/474342
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