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Saudi Journal of Kidney Diseases and Transplantation
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CASE REPORT Table of Contents   
Year : 2016  |  Volume : 27  |  Issue : 1  |  Page : 153-156
Malignant hypertension-associated thrombotic microangiopathy following cocaine use

1 Nephrology Department, La Rabta Hospital, Tunis, Tunisia
2 Laboratory of Renal Pathology (LR00SP01), Charles Nicolle Hospital, Tunis, Tunisia

Correspondence Address:
Rais Lamia
Nephrology Department, La Rabta Hospital, Jabbari, 1007, Tunis
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DOI: 10.4103/1319-2442.174195

PMID: 26787585

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Cocaine is one of the most commonly used illicit drugs with distribution and consumption throughout the world. Acute renal failure associated with rhabdomyolysis, direct vasoconstriction and hemodynamic alteration is well described in patients with cocaine intoxication. Cocaine use is associated with high blood pressure and may rarely induce malignant hypertension associated with thrombotic microangiopathy. We report the case of a patient who developed malignant hypertension associated with thrombotic microangiopathy after chronic consumption of cocaine. A kidney biopsy revealed thrombotic microangiopathy with fibrinoid necrosis of arterioles and glomerular tufts. He required dialysis sessions. Cocaine-mediated endothelial injury and platelet activation may play important pathogenetic roles in cocaine abusers who develop malignant hypertension associated with thrombotic microangiopathy. Clinicians need to be aware of this rare feature of cocaine intoxication.

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