![]() ![]() ![]() In 1596, cocaine was first used for medicinal purposes by a Spanish physician.Key events in the history of cocaine include the following: Cocaine has remained a vital part of the religious beliefs of the Andean peoples of Peru, Bolivia, Ecuador, Colombia, and northern Argentina and Chile from the pre-Inca period through the present. 2 Its stimulant properties have been known to mankind for more than 2000 years. In this article, we describe these syndromes and provide clues that help with early diagnosis and appropriate management of cocaine-induced rheumatologic mimics.Ĭocaine is a tropane ester alkaloid found in the leaves of Erythroxylum coca, a bush that grows in the Andes Mountains in South America. ![]() Prompt recognition of these syndromes is important for appropriate diagnosis and management because they often are confused and misdiagnosis results. 1 More than 70% of cocaine samples have been contaminated with levamisole, an immunomodulatory agent associated with multiple medical complications.Ĭocaine, especially contaminated cocaine, has been implicated in many rheumatologic conditions, such as cutaneous vasculitis, midline granulomatous lesions, cerebral vasculitis, and coronary aneurysms. Thirty million Americans have used cocaine, making the United States the world’s largest consumer of the substance there are about 5 million current users. Management strategies include making the diagnosis, gaining knowledge of the disorders that cocaine can mimic, and testing for cocaine and levamisole contaminant. Cocaine may have deleterious effects on the cardiovascular system. Cocaine-induced midline destructive lesions have been associated with cocaine. Levamisole was recently found to contaminate up to 70% of cocaine samples it has been postulated to cause various cutaneous lesions. ![]() Whether cocaine itself or in combination with host proteins is immunogenic and whether such a phenomenon has clinical relevance is unclear. The principal effects of cocaine are seen in the CNS and the corticomesolimbic dopamine reward pathway. Recognition of these syndromes is important for appropriate diagnosis and management because they often are confused and misdiagnosis results. ABSTRACT: Cocaine has been implicated in many rheumatologic conditions. ![]()
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