Acute renal failure, thrombocytopenia, and elevated liver enzymes after concurrent abuse of alcohol and cocaine

  • Alireza Hosseinnezhad | ali.hosseinnezhad@stvincenthospital.com Saint Vincent Hospital, United States.
  • Rajakrishnan Vijayakrishnan Saint Vincent Hospital, United States.
  • Mary Jo S. Farmer Saint Vincent Hospital Fallon Clinic, United States.

Abstract

Cocaine has been associated with known adverse effects on cardiac, cerebrovascular and pulmonary systems. However, the effect of cocaine on other organs has not been extensively reported. A middle age man presented with abdominal pain and nausea after inhalation of crack cocaine. On admission, he was found to be hypertensive and tachycardic. Physical examination revealed mild abdominal tenderness without rebound. Laboratory investigations were significant for acute kidney failure with elevated serum creatinine (3.72 mg/dL), thrombocytopenia (platelet count 74,000/UL), elevated alanine and aspartate transaminases (ALT 331 U/L; AST 462 U/L) and elevated creatine phosphokinase (CPK 5885 U/L). Urine toxicology screening solely revealed cocaine. A clinical diagnosis of cocaine toxicity was made and patient was admitted to the intensive care unit because of multi organ failure. Despite downward trending of liver enzymes during the hospital course, he continued to have residual renal insufficiency and a low platelet count at the time of discharge. In a patient with history of recent cocaine use presenting with these manifestations, cocaine itself should be considered as a likely cause.

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Author Biographies

Alireza Hosseinnezhad, Saint Vincent Hospital

Medical Resident, Department of Medicine

Rajakrishnan Vijayakrishnan, Saint Vincent Hospital
Medical Resident, Department of Medicine
Mary Jo S. Farmer, Saint Vincent Hospital Fallon Clinic
Attending Physician, Division of Pulmonary and Critical care medicine
Published
2011-05-16
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Section
Case Reports
Keywords:
cocaine toxicity, renal failure, thrombocytopenia, hepatitis.
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How to Cite
Hosseinnezhad, A., Vijayakrishnan, R., & Farmer, M. J. S. (2011). Acute renal failure, thrombocytopenia, and elevated liver enzymes after concurrent abuse of alcohol and cocaine. Clinics and Practice, 1(2), e35. https://doi.org/10.4081/cp.2011.e35