Figure 5.

The abuse of cocaine may result in a “spectrum of autoimmune manifestations” in predisposed individuals, ranging from localized to systemic effects. These manifestations, which may partially overlap, can ultimately be classified into three clinical entities: cocaine-induced midline destructive lesion (CIMDL), levamisole-adulterated cocaine (LAC) vasculopathy/vasculitis, and cocaine-induced vasculitis (CIV). AAV: ANCA-associated vasculitis; ANCA: anti-neutrophil cytoplasmatic antibody; CRP: C-reactive protein; ESR: erythrocyte sedimentation rate; HNE: human neutrophilic elastase; MPO: myeloperoxidase; p-ANCA: perinuclear-ANCA, PR3 proteinase 3.