Cocaïne et lésions destructrices centro-faciales : à propos d'un cas.

Authors :: Blaison F
Faganello D
Goigoux C
Mercié P
Baulier G
Contin-Bordes C
Duffau P
Source :: La Revue de medecine interne [Rev Med Interne] 2020 Sep; Vol. 41 (9), pp. 622-627. Date of Electronic Publication: 2020 Jul 11.
Publication Year :: 2020
Abstract: Introduction: Cocaine use is associated with multiple complications, some of which can mimic systemic diseases, especially Antineutrophil Cytoplasmic Antibody (ANCA) associated vasculitis. We report a case of Cocaine Induced Midline Destructive Lesions (CIMDL) for which a diagnosis of granulomatosis with polyangiitis (GPA) was discussed.<br />Case Report: A 42-year-old male, cocaine consumer, was admitted in our department for a centrofacial destructive process. He had no extra ear, nose and throat (ENT) involvement. ANCA were positive with a perinuclear fluorescence pattern and an anti-Proteinase 3 specificity. Regarding this unusual immunologic pattern and in the absence of histological argument for a GPA, a diagnosis of CIMDL was made.<br />Conclusion: CIMDL is a centrofacial destructive process due to intranasal cocaine use. It is frequently associated with the presence of p-ANCA with both anti-HNE and anti-PR3 specificity.<br /> (Copyright © 2020. Published by Elsevier Masson SAS.)