可卡因和左旋咪唑所致鼻科并发症患者的病例系列及文献综述
A case series and literature review on patients with rhinological complications secondary to the use of cocaine and levamisole.
作者信息
Green R J, Gardiner Q, Vinod K, Oparka R, Ross P D
机构信息
Department of ENT, Ninewells Hospital and Medical School, Dundee, Scotland, UK.
Department of Rheumatology, Ninewells Hospital and Medical School, Dundee, Scotland, UK.
出版信息
J Laryngol Otol. 2020 May;134(5):440-446. doi: 10.1017/S0022215120000894. Epub 2020 May 20.
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.
背景
左旋咪唑是一种越来越常用于与可卡因混合的切割剂。可卡因和左旋咪唑都可能对患者产生局部和全身影响。
方法
对2016年4月至2019年4月期间在邓迪医院或佩斯利一位外科医生诊所就诊的可卡因诱发中线破坏性病变或左旋咪唑诱发血管炎患者进行了一项回顾性病例系列研究。还对该主题进行了文献综述。
结果
从两个中心确定了9名患者。一名患者似乎患有左旋咪唑诱发的血管炎，蛋白酶3升高，核周抗中性粒细胞胞浆抗体呈阳性，且关节痛在使用全身类固醇后有所改善。其他8名患者具有可卡因诱发中线破坏性病变的特征。
结论
随着可卡因使用的增加，耳鼻喉科外科医生将看到更多与之相关的并发症。本文强调了一些诊断问题，并提出了一种管理策略，作为该复杂患者群体的指南。通常，需要多学科管理。
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