Eosinophilic 'empyema' associated with crack cocaine use
| Autor: | J Y Westcott, J A Biller, J L Morrison, J P Maloney, R M Effros, D H Strong |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2003 |
| Předmět: |
Pulmonary and Respiratory Medicine
Adult Male Pathology medicine.medical_specialty Pleural effusion Administration Oral Case Report Proinflammatory cytokine chemistry.chemical_compound Cocaine-Related Disorders Eosinophilic medicine Humans Pulmonary Eosinophilia Glucocorticoids Empyema Pleural business.industry respiratory system Eosinophil medicine.disease Empyema Vascular endothelial growth factor medicine.anatomical_structure chemistry Effusion Crack Cocaine Prednisone business Bronchoalveolar Lavage Fluid |
| Popis: | Smoking of crystalline cocaine, known as "crack" cocaine, has been associated with eosinophilic pneumonitis, but not with pleural effusions. We describe a patient with eosinophilic pneumonitis with an eosinophilic "empyema" after using "crack" cocaine. The illness resolved with corticosteroids. We hypothesised that his effusion would have increased levels of eosinophil cytokines that promote oedema, and found a marked increase in pleural vascular endothelial growth factor (VEGF) and smaller increases in interleukins IL-5, IL-6, and IL-8. In the setting of "crack" use, we suggest that a pleural effusion that appears grossly to be pus should be evaluated for eosinophilic inflammation. Such eosinophilic effusions may respond to corticosteroids alone, consistent with a non-infectious process driven by proinflammatory cytokines. |
| Databáze: | OpenAIRE |
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