TRUMP NASAL PROBLEMS
Researchers: Cocaine abuse can be mistaken for non-threatening nasal disease


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April 4 (UPI) -- A new paper by British researchers found that cocaine abuse in the nasal area often can be mistaken as a non-threatening nasal disease, resulting in patients receiving potentially dangerous treatments.

The paper detailing the research was posted Tuesday in the scientific journal Rheumatology Advances in Practice, published by Oxford University Press.

Authors of the paper conducting a retrospective review of patients who visited clinics at Queen Elizabeth Hospital in Birmingham and the Royal Free Hospital in London found cocaine abuse being misdiagnosed at times.

The abuse was mistaken as granulomatosis with polyangiitis, a nasal disease that causes inflammation of the blood vessels and commonly results in symptoms in the sinuses, throat, lungs and kidneys.

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The researchers said that many patients identified with the sinus and nasal limited form of the disease actually may have been suffering from nasal damage from cocaine use.

The authors said that while granulomatosis with polyangiitis, of GPA, is rare, affecting about three out of every 100,000 people, they believe that the possibility for misdiagnosis is serious because common treatments for GPA may be ineffective -- and even dangerous -- for ongoing cocaine users.

"This is an important paper that has changed our practice," said Aine Burns, one of the paper's authors. "We now include urine samples for drugs of abuse in our initial investigations of patients with GPA and in those who appear not to be responding to treatment."

In their review, researchers found out of the 42 patients with GPA, cocaine use was common among them. Urine tests confirmed 86% tested positive for cocaine.

"Sadly, we have seen young people with life-changing disfigurement because of cocaine-induced granulomatosis with polyangiitis. A better understanding of this condition prevents us from potentially harming patients further by administering inappropriate, potentially toxic, and futile treatments."

Burns said there currently needs to be a heightened awareness of the possible misdiagnosis among users, the public and healthcare professional

In Britain, cocaine is the second most abused drug with 2.6% of the population using it from the ages of 16 to 59. Cocaine can cause significant health problems, including cocaine-induced midline destructive lesions and various other health problems.

According to the Centers for Disease Control and Prevention, cocaine was involved in nearly 1 in 5 overdose deaths in 2019. More than five million U.S. residents reported current cocaine use in 2020, which is almost 2% of the population.


Non-Hispanic Black persons experienced the highest death rate for overdoses involving cocaine in 2019.

Both cocaine and GPA have similar general symptoms, such as arthralgia, fatigue, and skin rash, making it difficult to initially diagnose for physicians.