• Der Internist · Aug 2004

    Case Reports

    [Pulmonary infiltrates in a 19 year old patient with dysuria and hypercalcemia].

    • R Schnaitmann, M Hack, F Gläser, B Schütze, E Tsegai, and G Kleber.
    • Medizinische Klinik I, Ostalb-Klinikum Aalen.
    • Internist (Berl). 2004 Aug 1;45(8):940-5.

    AbstractA 19 year old patient presented with the typical constellation of sarcoidosis. In the presence of indefinable pulmonary infiltrates, hypercalcemia, raised angiotensin converting enzyme and even evidence of giant and epitheloid cell granulomas, cocaine abuse should be considered. Chronic inhalative cocaine abuse can cause foreign body associated granulomatosis of the lung and other organs. It is important to establish this differential diagnosis by confidential interview and systematic polarisation microscopy to detect foreign material in tissues: unnecessary therapies with potential side effects should be avoided and drug weaning with rehabilitation of the patient should be initiated. However the potential for rapid progressive respiratory failure should not be underestimated.

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