A case series and literature review on patients with rhinological complications secondary to the use of cocaine and levamisole

R. J. Green (Lead / Corresponding author), Q. Gardiner, K. Vinod, R. Oparka, P. D. Ross

Research output: Contribution to journalArticle

Abstract

Background: Levamisole is an increasingly common cutting agent used with cocaine. Both cocaine and levamisole can have local and systemic effects on patients.

Methods: A retrospective case series was conducted of patients with a cocaine-induced midline destructive lesion or levamisole-induced vasculitis, who presented to a Dundee hospital or the practice of a single surgeon in Paisley, from April 2016 to April 2019. A literature review on the topic was also carried out.

Results: Nine patients from the two centres were identified. One patient appeared to have levamisole-induced vasculitis, with raised proteinase 3, perinuclear antineutrophil cytoplasmic antibodies positivity and arthralgia which improved on systemic steroids. The other eight patients had features of a cocaine-induced midline destructive lesion.

Conclusion: As the use of cocaine increases, ENT surgeons will see more of the complications associated with it. This paper highlights some of the diagnostic issues and proposes a management strategy as a guide to this complex patient group. Often, multidisciplinary management is needed.

Original languageEnglish
Number of pages7
JournalJournal of Laryngology and Otology
Early online date20 May 2020
DOIs
Publication statusE-pub ahead of print - 20 May 2020

Keywords

  • Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis
  • Cocaine
  • Deformities
  • Nasal Obstruction
  • Nose

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