Cocaine-Induced Acute Interstitial Nephritis: A Comparative Review of 7 Cases

Cocaine Hurts Your Kidneys Too: A Rare Case of Acute Interstitial Nephritis Caused by Cocaine Abuse

Cocaine is a powerfully addictive recreational drug that is extracted from the leaves of the Erythroxylon coca plant native to Central and South America. It is a widely abused substance, despite being banned since the early 19th century due to fatalities. Cocaine may result in acute kidney injury (AKI) by different mechanisms, but acute interstitial nephritis (AIN) is scarcely recognized as the cause of acute kidney injury (AKI). Here, we present a case of AKI from both AIN and acute tubular necrosis (ATN) following cocaine insufflation. The purpose of this article is to review the rare but significant association of AIN associated with cocaine use. The nature of the treatment of cocaine-related kidney disease may differ from other causes of acute kidney insult. Prompt recognition of the underlying cause of renal dysfunction is vital for this group of patients to prevent the rapid deterioration of renal function.

Acute pancreatitis secondary to cocaine use: a case-based systematic literature review

Cocaine use continues to be an important global public health problem. As the use of cocaine remains pervasive so have a myriad of adverse events associated with this drug. These deleterious effects are well-studied, but gastrointestinal complications remain esoteric and the existing clinical evidence is scarce. Ischemia of the esophagus and small bowel, perforation, peptic ulceration, gastrointestinal bleeding, and ischemic colitis are among the reported complications. In specific, acute pancreatitis secondary to cocaine use is an exceedingly rare clinicopathologic entity. To date, only 7 cases of this condition have been reported in the English-language literature. We hereby delineate a rare case of a 29-year-old female who developed her first episode of cocaine-associated pancreatitis. The diagnosis was made based on a standard battery of investigations and meticulous exclusion of common etiologies of acute pancreatitis. To our knowledge, this case represents the first report of re-occurrence of acute pancreatitis upon subsequent crack cocaine insufflation, adding a higher level of evidence to a fallible association. We also present a systematic review of the existing literature on acute pancreatitis following cocaine use. An updated knowledge regarding this rare association is of paramount importance for early diagnosis and astute management.

Cocaine nephropathy: A rare cause of abnormal nephrograms

Cocaine use is associated with a variety of renal injuries. Although rhabdomyolysis is the most common cause of cocaine-induced nephropathy, cocaine can also cause renal vasculitis, acute interstitial nephritis, acute tubular necrosis, thrombotic microangiopathy, and renal infarction. We present a rare case of cocaine-induced nephropathy in a 30-year-old male who presented with acute kidney injury and abnormal nephrograms at contrast-enhanced computed tomography. Mechanisms of cocaine-induced renal injury and differential causes of abnormal nephrograms encountered at imaging are discussed. Cocaine-induced nephropathy is a rare but important cause of abnormal nephrograms and should be considered in the differential diagnosis when clinically appropriate.