Home | Business News | Browse by Publication | J | Journal of Respiratory Diseases

Severe emphysema associated with cocaine smoking.

Article Excerpt
Byline: Bobbak Vahid, MD and Paul E. Marik, MD

Cocaine use is associated with a variety of pulmonary pathologies, including noncardiogenic pulmonary edema, alveolar hemorrhage, interstitial fibrosis, organizing pneumonia, foreign-body reaction, and granuloma formation. Severe premature emphysema is a rarely reported complication of cocaine smoking. We report a case of severe emphysema and cardiomyopathy in a woman who was not a cigarette smoker but had a long-standing history of cocaine use.

Emphysema is a common disease in smokers. Chronic obstructive pulmonary disease (COPD), which includes emphysema, develops in about 15% of active smokers.1

a1-Antitrypsin deficiency also has been identified as a risk factor for the development of emphysema. However, emphysema does not develop in all persons with a1-antitrypsin deficiency. Other risk factors, such as cigarette smoking, occupational dust exposure, family history of COPD, and lower respiratory tract infection, may be necessary for the development of lung disease.2

Cases of severe premature emphysema in nonsmokers with normal a1-antitrypsin activity have been described in the literature.3,4 We describe a 49-year-old female nonsmoker who presented with severe cardiomyopathy and severe emphysema after a prolonged history of cocaine use. To the best of our knowledge, this is the second case of cocaine-associated pulmonary emphysema described in English literature. The subject of emphysema in nonsmokers and in those who do not have a1-antitrypsin deficiency is also reviewed.

The case

A 49-year-old woman was admitted to the hospital with severe dyspnea and cough. She reported gradually progressive...

View this article FREE - Now for a Limited Time, try Goliath Business News
Free for 3 Days!