Acute hepatitis due to nasal cocaine use: clinical case report and literature review

Barbara Gauchet (1), Véronique Gerard (2), Hadrien Fourneau (3) Published in the journal : January 2021 Category : Emergency

Summary :

We present the case report of a 28-year-old man admitted to the emergency department for acute hepatitis due to nasal cocaine use. Cocaine abuse is associated with a variety of acute medical complications. Acute hepatitis without other systemic disorders is a rare condition that may occur following cocaine use.

Based on a systematic review of the literature, this report seeks to discuss the clinical, biological, and histopathological features of this disease and its evolution, too. The clinical practice guidelines for managing acute hepatitis due to cocaine use will be discussed, as well.

This case provides us the opportunity to remember and explore the differential diagnosis of acute hepatitis and the usefulness of a precise anamnesis.

What is already known about the topic?

- Acute hepatitis is a medical emergency, given that it can provoke hepatic failure associated with encephalopathy.

- This condition is associated with high morbi-mortality rates, owing to its numerous complications. This explains the relevance of a rapid etiological diagnosis to provide the best medical care in an appropriate unit.

- Cocaine consumption can provoke numerous acute organic complications.

What does this article bring up for us?

- This article highlights that acute hepatitis can represent the sole clinical manifestation of cocaine consumption, without any other organ failures. This hepatic condition is rare and not well understood by the medical community. It is difficult to make a precise etiological diagnosis.

- Cocaine-induced hepatotoxicity is related to its metabolites, and its histopathological patterns are similar to those observed in ischemic hepatitis.

- There is no curative treatment.

- Intensive care unit admission is required if acute hepatitis is associated with coagulopathy.

Key Words

Acute hepatitis, cocaine, hepatotoxicity, toxicological history