Damage from Cocaine Abuse can be Misdiagnosed as Granulomatosis with Polyangiitis


The damage caused by cocaine can sometimes be misdiagnosed as a rare disease: granulomatosis with polyangiitis. Cocaine use has been increasing in America and the UK, resulting in serious health issues. Most frequently, however, it results in severe, disfiguring, nasal and sinus damage.

Cocaine, a stimulant that comes from South American coca plant, is an addictive substance. In fact, according to an article in Health and Medicine, it is perhaps second to the most addictive substance worldwide.

That does not seem to deter users as it is one of the most abused drugs in the United Kingdom (2.6 percent of adults) and in America, that number exceeds 4.8 million users last year.

Using cocaine frequently lulls the brain into becoming accustomed to the drug. At that point, not using it causes mood changes such as irritability or depression, causing the user to spend more time focusing on the drug rather than on normal daily activities.

Cocaine causes damage to the heart and puts the user at an increased risk of a stroke. But a recent study indicated that damage to the nasal passages and sinus is often diagnosed as granulomatosis with polyangiitis (GPA).

GPA is characterized by inflammation located in the blood vessels in the sinuses, nose, lungs, and throat. It is associated with a disorder called vasculitis and can affect anyone, even children.

It has been suggested that the immune system may cause GPA if immunosuppressants were used in error.

Recent studies show that the use of cocaine produces antibodies with symptoms in line with those of GPA patients. Doctors, therefore, find it difficult to properly diagnose damage associated with drug use. The symptoms are usually accompanied by skin rashes, joint pain (arthralgia), and fatigue.

GPA is not common. It affects three patients out of approximately 100,000 individuals. Yet studies indicate that misdiagnosing symptoms resulting from cocaine use is dangerous. Treatment often includes immunosuppressants that carry significant risks, notably infections.

To test their findings, researchers instituted a review of patients who were previously treated at London’s Royal Free Hospital and the Queen Elizabeth Hospital located in Birmingham from 2016 through 2021.

42 patients disclosed their cocaine use. Subsequently, other patients were found to be cocaine users through the use of urine toxicology. These patients exhibited GPA symptoms.

Ten patients who had participated in the clinics received a GPA diagnosis at the time. Although they were treated with immunosuppressive drugs, they continued to experience nasal issues.

The researchers found the results to be troubling. Data show evidence that cocaine-induced vasculitis is much more prevalent than previously reported.

A contributing author, Dr. Aine Burns, stated that not only is the paper important. but it has changed their practice.

Urine samples are now included in investigations of GPA patients as well as those patients who are refractory to treatment.

Dr. Burns stated that she and her colleagues have witnessed patients with disfigurement caused by cocaine-induced granulomatosis with polyangiitis.

The doctor emphasized that an improved understanding of the subject would preclude the medical community from causing additional harm. A proper diagnosis would eliminate misconceptions and create a heightened awareness among cocaine users, healthcare professionals, and the public.


Rose Duesterwald

Rose Duesterwald

Rose became acquainted with Patient Worthy after her husband was diagnosed with Acute Myeloid Leukemia (AML) six years ago. During this period of partial remission, Rose researched investigational drugs to be prepared in the event of a relapse. Her husband died February 12, 2021 with a rare and unexplained occurrence of liver cancer possibly unrelated to AML.

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