Hirche T O, Lambrecht E, Wagner T O
Zentrum für Innere Medizin II, Schwerpunkt Pneumologie und Allergologie, Germany.
Pneumologie. 2002 Nov;56(11):684-8. doi: 10.1055/s-2002-35552.
A 45-year-old patient developed shortness of breath, intensive cough, hemoptysis, chest pain and acute bilateral pulmonary infiltrates following the inhalation of crack-cocaine. The bronchoalveolar lavage and transbronchial biopsy revealed infiltrations of polymorphonuclear neutrophils and the formation of foreign body granulomas. The diagnosis of a crack-syndrome was made and the patient rapidly improved under temporary discontinuation of cocaine inhalation and symptomatic therapy. Crack-cocaine is the free-base of cocaine-hydrochloride and its chemical properties allows it to be inhaled tobacco-like. Therefore the lungs become the principal organs exposed and affected. In addition to our findings, diffuse damage of the alveolar wall and capillary injury due to vasoconstriction and toxic action were reported, in some cases rapidly progressing into pulmonary oedema and ARDS. As the consumption of crack cocaine in Germany has markedly increased over the past decade, a higher prevalence of the reported syndrome has to be assumed.
一名45岁患者在吸入快克可卡因后出现呼吸急促、剧烈咳嗽、咯血、胸痛及双侧肺部急性浸润。支气管肺泡灌洗和经支气管活检显示多形核中性粒细胞浸润及异物肉芽肿形成。诊断为快克综合征，在暂时停止吸入可卡因并进行对症治疗后，患者病情迅速改善。快克可卡因是盐酸可卡因的游离碱，其化学性质使其可像烟草一样被吸入。因此，肺部成为主要暴露和受影响的器官。除了我们的发现外，还报道了由于血管收缩和毒性作用导致的肺泡壁弥漫性损伤和毛细血管损伤，在某些情况下会迅速发展为肺水肿和急性呼吸窘迫综合征。由于在过去十年中德国快克可卡因的消费量显著增加，因此可以推测该报告综合征的患病率会更高。
