Difference between revisions of "Cocaine toxicity"
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[[Image: CocaineHydrochloridePowder.jpg | thumb | 250px | Cocaine. (WC/US DEA)]] | |||
'''Cocaine toxicity''' is seen in by pathologists in the [[forensic pathology|forensic]] setting. | '''Cocaine toxicity''' is seen in by pathologists in the [[forensic pathology|forensic]] setting. | ||
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**Direct effects of norepinephrine on myocytes | **Direct effects of norepinephrine on myocytes | ||
**Vasospasm leading to myocardial ischemia. | **Vasospasm leading to myocardial ischemia. | ||
*Main metabolite (found in urine): benzoylecgonine.<ref name=pmid21664118>{{Cite journal | last1 = Munoz | first1 = EM. | last2 = Lorenzo-Abalde | first2 = S. | last3 = González-Fernández | first3 = A. | last4 = Quintela | first4 = O. | last5 = Lopez-Rivadulla | first5 = M. | last6 = Riguera | first6 = R. | title = Direct surface plasmon resonance immunosensor for in situ detection of benzoylecgonine, the major cocaine metabolite. | journal = Biosens Bioelectron | volume = 26 | issue = 11 | pages = 4423-8 | month = Jul | year = 2011 | doi = 10.1016/j.bios.2011.04.056 | PMID = 21664118 }}</ref> | |||
==Gross pathology== | ==Gross pathology== | ||
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==Microscopic== | ==Microscopic== | ||
Features (heart):<ref name=pmid1346509/> | Features (heart):<ref name=pmid1346509/> | ||
*+/-Large areas of confluent necrosis. | *+/-Large areas of confluent [[necrosis]]. | ||
*+/-Contraction band necrosis. | *+/-[[Contraction band necrosis]]. | ||
*+/-Fibrosis. | *+/-Fibrosis. | ||
*+/-Myocarditis (usu. eosinophilic). | *+/-[[Myocarditis]] (usu. eosinophilic). | ||
==See also== | ==See also== | ||
Latest revision as of 04:58, 28 December 2014
Cocaine toxicity is seen in by pathologists in the forensic setting.
General
- Anatomical findings at autopsy are uncommon (most common situation) or non-specific (atherosclerosis +/- acute thrombosis).[1]
- Toxicity mechanisms:
- Direct effects of norepinephrine on myocytes
- Vasospasm leading to myocardial ischemia.
- Main metabolite (found in urine): benzoylecgonine.[2]
Gross pathology
Features (heart):[3]
- +/-Atherosclerosis out of keeping with age.
- +/-Large areas of confluent necrosis.
- +/-Fibrosis.
Microscopic
Features (heart):[3]
- +/-Large areas of confluent necrosis.
- +/-Contraction band necrosis.
- +/-Fibrosis.
- +/-Myocarditis (usu. eosinophilic).
See also
References
- ↑ Virmani R (1991). "Cocaine-associated cardiovascular disease: clinical and pathological aspects". NIDA Res. Monogr. 108: 220–9. PMID 1749414.
- ↑ Munoz, EM.; Lorenzo-Abalde, S.; González-Fernández, A.; Quintela, O.; Lopez-Rivadulla, M.; Riguera, R. (Jul 2011). "Direct surface plasmon resonance immunosensor for in situ detection of benzoylecgonine, the major cocaine metabolite.". Biosens Bioelectron 26 (11): 4423-8. doi:10.1016/j.bios.2011.04.056. PMID 21664118.
- ↑ 3.0 3.1 Kloner RA, Hale S, Alker K, Rezkalla S (February 1992). "The effects of acute and chronic cocaine use on the heart". Circulation 85 (2): 407–19. PMID 1346509. http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=1346509.