This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citing articles on HighWire  • Citing articles on ISI (2)  • Contact me when this article is cited  Related Content  • Related letters  • Similar articles in JAMA  Topic Collections  • Substance Abuse/ Alcoholism  • Liver/ Biliary Tract/ Pancreatic Diseases  • Viral Infections  • Alert me on articles by topic

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: Cocaine abuse has been separately associated with acute hepatitis and thrombotic microangiopathy (TMA); however, we are not aware of prior case reports of their simultaneous occurrence.

Report of a Case

A 22-year-old woman was hospitalized because of weakness, vomiting, fever, and jaundice for 3 days. She had consumed ethanol (80 g/d) and intravenous cocaine (1-2 g/wk) for the last 3 years but reported an increase in cocaine consumption in the previous week (>2 g/d). Chronic hepatitis C virus (HCV) was diagnosed 1 year earlier; at that time, her levels of transaminases, serum bilirubin, serum albumin, and her international normalized ratio (INR) were normal. On admission, physical examination was normal except for the presence of jaundice. She initially had markedly elevated transaminases (aspartate aminotransferase: 1264 U/L; alanine aminotransferase: 1305 U/L); increased alkaline phosphatase (308 U/L), -glutamyltransferase (110 U/L), and serum total bilirubin (12 mg/dL [205.2 µmol/L]); an albumin level of 34 g/L, . . . [Full Text of this Article]

Francesc Balaguer, MD; Javier Fernández, MD
jfdez@clinic.ub.es
Liver Unit
Institut de Malalties Digestives

Miguel Lozano, MD
Hemotherapy and Hemostasis Department

Rosa Miquel, MD
Pathology Department

Antoni Mas, MD
Liver Unit
Institut de Malalties Digestives
Hospital Clinic Barcelona
University of Barcelona
Barcelona, Spain

RELATED LETTERS

Cocaine-Induced Acute Hepatitis and Thrombotic Microangiopathy
Alaa M. Abd El-Rahman and Hussam Ammar
JAMA. 2005;293(22):2715.
EXTRACT | FULL TEXT  

Cocaine-Induced Acute Hepatitis and Thrombotic Microangiopathy—Reply
Javier Fernández, Francesc Balaguer, and Miguel Lozano
JAMA. 2005;293(22):2715-2716.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Cocaine-Induced Acute Hepatitis and Thrombotic Microangiopathy
El-Rahman and Ammar
JAMA 2005;293:2715-2715.
FULL TEXT