title: Malignant hypertension-associated thrombotic microangiopathy following cocaine use.
abstract: Cocaine is one of the most commonly used illicit drugs with distribution and consumption throughout the world. Acute renal failure associated with rhabdomyolysis, direct vasoconstriction and hemodynamic alteration is well described in patients with cocaine intoxication. Cocaine use is associated with high blood pressure and may rarely induce malignant hypertension associated with thrombotic microangiopathy. We report the case of a patient who developed malignant hypertension associated with thrombotic microangiopathy after chronic consumption of cocaine. A kidney biopsy revealed thrombotic microangiopathy with fibrinoid necrosis of arterioles and glomerular tufts. He required dialysis sessions. Cocaine-mediated endothelial injury and platelet activation may play important pathogenetic roles in cocaine abusers who develop malignant hypertension associated with thrombotic microangiopathy. Clinicians need to be aware of this rare feature of cocaine intoxication.
authors.affiliation: Nephrology Department, La Rabta Hospital, Tunis, Tunisia.
authors.forename: Rais
authors.initials: R
authors.lastname: Lamia
authors.forename: Zohra
authors.initials: Z
authors.lastname: El Ati
authors.forename: Lilia
authors.initials: L
authors.lastname: Ben Fatma
authors.forename: Karim
authors.initials: K
authors.lastname: Zouaghi
authors.forename: Wided
authors.initials: W
authors.lastname: Smaoui
authors.forename: Khedher
authors.initials: K
authors.lastname: Rania
authors.forename: Madiha
authors.initials: M
authors.lastname: Krid
authors.forename: Fathi
authors.initials: F
authors.lastname: Ben Hmida
authors.forename: Soumaya
authors.initials: S
authors.lastname: Béji
authors.forename: Fatma
authors.initials: F
authors.lastname: Ben Moussa
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D000328:Adult; D001706:Biopsy; D001794:Blood Pressure; D019970:Cocaine-Related Disorders / Q000150:complications*; D006801:Humans; D006974:Hypertension, Malignant / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D007668:Kidney / Q000473:pathology*; D008297:Male; D006435:Renal Dialysis