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Crack lung: an acute pulmonary syndrome with a spectrum of clinical and histopathologic findings.
Am Rev Respir Dis. 1990 Aug; 142(2):462-7.AR

Abstract

In this report, we review the hospital course of four patients who presented with an acute pulmonary syndrome after inhaling freebase cocaine and compare them with previously described case reports. Two patients had prolonged inflammatory pulmonary injury associated with fever, hypoxemia, hemoptysis, respiratory failure, and diffuse alveolar infiltrates. Lung tissue specimens from both patients revealed diffuse alveolar damage, alveolar hemorrhage, and interstitial and intraalveolar inflammatory cell infiltration notable for the prominence of eosinophils. Immunofluorescent staining performed on one of the biopsy specimens showed a striking deposition of IgE in both lymphocytes and alveolar macrophages. Both patients were treated with systemic corticosteroids and rapidly improved. In contrast, two patients presented acutely with diffuse pulmonary alveolar infiltrates associated with dyspnea and hypoxemia, but without fever, and within 36 h of discontinuing cocaine their pulmonary infiltrates and symptoms had spontaneously resolved. Our report further supports the finding that an acute pulmonary syndrome can occur after inhalation of freebase cocaine. Furthermore, the lung injury may respond to systemic corticosteroid therapy when it is associated with a prominent inflammatory cell infiltration.

Authors+Show Affiliations

University of Colorado Health Science Center, Division of Pulmonary Sciences, Denver 80262.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

2382909

Citation

Forrester, J M., et al. "Crack Lung: an Acute Pulmonary Syndrome With a Spectrum of Clinical and Histopathologic Findings." The American Review of Respiratory Disease, vol. 142, no. 2, 1990, pp. 462-7.
Forrester JM, Steele AW, Waldron JA, et al. Crack lung: an acute pulmonary syndrome with a spectrum of clinical and histopathologic findings. Am Rev Respir Dis. 1990;142(2):462-7.
Forrester, J. M., Steele, A. W., Waldron, J. A., & Parsons, P. E. (1990). Crack lung: an acute pulmonary syndrome with a spectrum of clinical and histopathologic findings. The American Review of Respiratory Disease, 142(2), 462-7.
Forrester JM, et al. Crack Lung: an Acute Pulmonary Syndrome With a Spectrum of Clinical and Histopathologic Findings. Am Rev Respir Dis. 1990;142(2):462-7. PubMed PMID: 2382909.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Crack lung: an acute pulmonary syndrome with a spectrum of clinical and histopathologic findings. AU - Forrester,J M, AU - Steele,A W, AU - Waldron,J A, AU - Parsons,P E, PY - 1990/8/1/pubmed PY - 1990/8/1/medline PY - 1990/8/1/entrez SP - 462 EP - 7 JF - The American review of respiratory disease JO - Am Rev Respir Dis VL - 142 IS - 2 N2 - In this report, we review the hospital course of four patients who presented with an acute pulmonary syndrome after inhaling freebase cocaine and compare them with previously described case reports. Two patients had prolonged inflammatory pulmonary injury associated with fever, hypoxemia, hemoptysis, respiratory failure, and diffuse alveolar infiltrates. Lung tissue specimens from both patients revealed diffuse alveolar damage, alveolar hemorrhage, and interstitial and intraalveolar inflammatory cell infiltration notable for the prominence of eosinophils. Immunofluorescent staining performed on one of the biopsy specimens showed a striking deposition of IgE in both lymphocytes and alveolar macrophages. Both patients were treated with systemic corticosteroids and rapidly improved. In contrast, two patients presented acutely with diffuse pulmonary alveolar infiltrates associated with dyspnea and hypoxemia, but without fever, and within 36 h of discontinuing cocaine their pulmonary infiltrates and symptoms had spontaneously resolved. Our report further supports the finding that an acute pulmonary syndrome can occur after inhalation of freebase cocaine. Furthermore, the lung injury may respond to systemic corticosteroid therapy when it is associated with a prominent inflammatory cell infiltration. SN - 0003-0805 UR - https://wwww.unboundmedicine.com/medline/citation/2382909/Crack_lung:_an_acute_pulmonary_syndrome_with_a_spectrum_of_clinical_and_histopathologic_findings_ L2 - https://www.atsjournals.org/doi/10.1164/ajrccm/142.2.462?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -