ISSN 1941-5923


Welcome to the American Journal of Case Reports

Clinical case reports are an invaluable first-hand source of evidence in medicine and a tool most often used in practice to exchange information and generate a more expanded search for evidence. In addition to the “evidence of what happened”, single or multiple cases are an important basis for further and more advanced research on diagnosis,  treatment effectiveness, causes and outcomes of disease. However limited their... read more

Published: 2015-05-24

Cocaine-Induced Delayed Recurrent Vasculitis: A 4-Year Follow-Up

Meera Yogarajah, Mona Pervil-Ulysse, Bhradeev Sivasambu

(Department of Medicine, Interfaith Medical Center, Brooklyn, NY, USA)

Am J Case Rep 2015; 16:310-314

DOI: 10.12659/AJCR.893550

Background: Cocaine is a highly abused substance in United States with almost 70 % of cocaine adulterated with levamisole. It is known to cause vasculitis involving multiple organs due to its direct toxic effect and by the contribution of levamisole or a combined effect of both.
Case Report: A 51-year-old woman complained of painful erythematous rash in her hands and lower extremities that started few hours after smoking cocaine and progressed to blistering dark lesions in her lower extremities. She denied any other systemic complaints. Although she has been smoking cocaine for more than 35 years, these skin eruptions started only 4 years ago. Examination revealed tender retiform purpura in the hand and tender retiform purpura with hemorrhagic bulla in the legs. Initially, she had only a significantly positive atypical p-ANCA and later developed combined positivity of both Myeloperoxidase (MPO) and Anti-proteinase-3(PR3) antibodies with a p-ANCA pattern on immunofluorescence. We report a unique case of cocaine (likely contaminated with levamisole)-induced delayed recurrent vasculitis with varying vasculitic antibodies over the years.
Conclusions: This case highlights the fact that patients can develop cocaine-related vasculitis after many years of uneventful abuse. Cocaine, with its adulterant levamisole, has the propensity to trigger diverse immunological reactions, which is evident by the varying antibody profile seen in the same patient over time.

Keywords: Cocaine, Levamisole, Vasculitis

Published: 2015-05-22

A Mass in the Junction of the Body and Tail of the Pancreas with Negative IgG4 Serology: IgG4-Related Dis...

Eduardo A. Rodriguez, Frederick K. Williams

Am J Case Rep 2015; 16:305-309

DOI: 10.12659/AJCR.893300

Published: 2015-05-20

Leiomyomatosis Peritonealis Disseminata Positive for Progesterone Receptor

Takashi Yuri, Yuichi Kinoshita, Michiko Yuki, Katsuhiko Yoshizawa, Yuko Emoto, Airo Tsubura

Am J Case Rep 2015; 16:300-304

DOI: 10.12659/AJCR.893570