Cocaine-induced renal infarction: report of a case and review of the literature

<p>Abstract</p> <p>Background</p> <p>Cocaine abuse has been known to have detrimental effects on the cardiovascular system. Its toxicity has been associated with myocardial ischemia, cerebrovascular accidents and mesenteric ischemia. The pathophysiology of cocaine-relat...

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Main Authors: Nosrati Saeid M, Motallebi Mazda, Bemanian Shahrooz
Format: Article
Language:English
Published: BMC 2005-09-01
Series:BMC Nephrology
Online Access:http://www.biomedcentral.com/1471-2369/6/10
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spelling doaj-130e2611d9c64ba39ef6a6b54eda51532020-11-25T01:49:16ZengBMCBMC Nephrology1471-23692005-09-01611010.1186/1471-2369-6-10Cocaine-induced renal infarction: report of a case and review of the literatureNosrati Saeid MMotallebi MazdaBemanian Shahrooz<p>Abstract</p> <p>Background</p> <p>Cocaine abuse has been known to have detrimental effects on the cardiovascular system. Its toxicity has been associated with myocardial ischemia, cerebrovascular accidents and mesenteric ischemia. The pathophysiology of cocaine-related renal injury is multifactorial and involves renal hemodynamic changes, alterations in glomerular matrix synthesis, degradation and oxidative stress, and possibly induction of renal atherogenesis. Renal infarction as a result of cocaine exposure, however, is rarely reported in the literature.</p> <p>Case presentation</p> <p>A 48 year-old male presented with a four-day history of severe right flank pain following cocaine use. On presentation, he was tachycardic, febrile and had severe right costovertebral angle tenderness. He had significant proteinuria, leukocytosis and elevated serum creatinine and lactate dehydrogenase. Radiographic imaging studies as well as other screening tests for thromboembolic events, hypercoagulability states, collagen vascular diseases and lipid disorders were suggestive of Cocaine-Induced Renal Infarction (CIRI) by exclusion.</p> <p>Conclusion</p> <p>In a patient with a history of cocaine abuse presenting with fevers and flank pain suggestive of urinary tract infection or nephrolithiasis, cocaine-induced renal infarction must be considered in the differential diagnosis. In this article, we discuss the prior reported cases of CIRI and thoroughly review the literature available on this disorder. This is important for several reasons. First, it will allow us to discuss and elaborate on the mechanism of renal injury caused by cocaine. In addition, this review will demonstrate the importance of considering the diagnosis of CIRI in a patient with documented cocaine use and an atypical presentation of acute renal injury. Finally, we will emphasize the need for a consensus on optimal treatment of this disease, for which therapy is not yet standardized.</p> http://www.biomedcentral.com/1471-2369/6/10
collection DOAJ
language English
format Article
sources DOAJ
author Nosrati Saeid M
Motallebi Mazda
Bemanian Shahrooz
spellingShingle Nosrati Saeid M
Motallebi Mazda
Bemanian Shahrooz
Cocaine-induced renal infarction: report of a case and review of the literature
BMC Nephrology
author_facet Nosrati Saeid M
Motallebi Mazda
Bemanian Shahrooz
author_sort Nosrati Saeid M
title Cocaine-induced renal infarction: report of a case and review of the literature
title_short Cocaine-induced renal infarction: report of a case and review of the literature
title_full Cocaine-induced renal infarction: report of a case and review of the literature
title_fullStr Cocaine-induced renal infarction: report of a case and review of the literature
title_full_unstemmed Cocaine-induced renal infarction: report of a case and review of the literature
title_sort cocaine-induced renal infarction: report of a case and review of the literature
publisher BMC
series BMC Nephrology
issn 1471-2369
publishDate 2005-09-01
description <p>Abstract</p> <p>Background</p> <p>Cocaine abuse has been known to have detrimental effects on the cardiovascular system. Its toxicity has been associated with myocardial ischemia, cerebrovascular accidents and mesenteric ischemia. The pathophysiology of cocaine-related renal injury is multifactorial and involves renal hemodynamic changes, alterations in glomerular matrix synthesis, degradation and oxidative stress, and possibly induction of renal atherogenesis. Renal infarction as a result of cocaine exposure, however, is rarely reported in the literature.</p> <p>Case presentation</p> <p>A 48 year-old male presented with a four-day history of severe right flank pain following cocaine use. On presentation, he was tachycardic, febrile and had severe right costovertebral angle tenderness. He had significant proteinuria, leukocytosis and elevated serum creatinine and lactate dehydrogenase. Radiographic imaging studies as well as other screening tests for thromboembolic events, hypercoagulability states, collagen vascular diseases and lipid disorders were suggestive of Cocaine-Induced Renal Infarction (CIRI) by exclusion.</p> <p>Conclusion</p> <p>In a patient with a history of cocaine abuse presenting with fevers and flank pain suggestive of urinary tract infection or nephrolithiasis, cocaine-induced renal infarction must be considered in the differential diagnosis. In this article, we discuss the prior reported cases of CIRI and thoroughly review the literature available on this disorder. This is important for several reasons. First, it will allow us to discuss and elaborate on the mechanism of renal injury caused by cocaine. In addition, this review will demonstrate the importance of considering the diagnosis of CIRI in a patient with documented cocaine use and an atypical presentation of acute renal injury. Finally, we will emphasize the need for a consensus on optimal treatment of this disease, for which therapy is not yet standardized.</p>
url http://www.biomedcentral.com/1471-2369/6/10
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