{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T11:18:20Z","timestamp":1792840700064,"version":"4.5.0"},"reference-count":42,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,12,12]],"date-time":"2023-12-12T00:00:00Z","timestamp":1702339200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2023,12,12]],"date-time":"2023-12-12T00:00:00Z","timestamp":1702339200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>In this multicentric study involving three London hospitals, we compared ANCA\u2010positive and ANCA\u2010negative cocaine\u2010induced midline destructive lesions (CIMDL) patients to assess how presence of antineutrophil cytoplasmic antibodies (ANCA) may correlate with disease severity. Our secondary aims are to better classify etiology centered around ANCA positivity and, consequently, better disease management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective review was performed to identify patients with CIMDL seen between January 2019 and December 2022. Population data including age, sex, presentation, endoscopic findings, duration of cocaine use and active use of cocaine, type of treatment, laboratory (including ANCA serology), radiological, and histological findings were collected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Forty CIMDL patients (25 male, median age of 42\u2009years) were identified. The majority of them (72.5%) presented with either a septal perforation, a saddle nose deformity (22.5%), and\/or a palatal fistula (20.0%). ANCA was positive in 71.1% of cases (66.7% p\u2010ANCA). No statistically significant differences in the general characteristics, type of treatment, laboratory results, radiological or histological findings were observed when comparing ANCA\u2010positive and ANCA\u2010negative CIMDL patients or when comparing p\u2010ANCA and c\u2010ANCA patients. Similarly, no statistically significant difference was obtained when comparing the pattern of distribution of lesions between the two groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A large percentage of CIMDL patients showed positive ANCA test (71.1%) and in the majority of the cases a p\u2010ANCA pattern specifically targeting PR3 (p\u2010ANCA, PR3\u2009+\u2009MPO\u2010). However, ANCA positivity or presence of a specific ANCA pattern was\u00a0not associated with more severe presentation or more aggressive disease. Given its similarities to granulomatosis with polyangiitis (GPA), we recommend the use of the term \u201ccocaine\u2010induced ENT pseudo\u2010GPA\u201d instead of CIMDL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>\n                      IV\n                      <jats:italic>Laryngoscope<\/jats:italic>\n                      , 134:2609\u20132616, 2024\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.31219","type":"journal-article","created":{"date-parts":[[2023,12,12]],"date-time":"2023-12-12T17:44:24Z","timestamp":1702403064000},"page":"2609-2616","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["The role of ANCA in the management of cocaine\u2010induced midline destructive lesions or ENT pseudo\u2010granulomatosis with polyangiitis: a London multicentre case series"],"prefix":"10.1002","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6348-5303","authenticated-orcid":false,"given":"Alfonso Luca","family":"Pendolino","sequence":"first","affiliation":[{"name":"Department of ENT Royal National ENT &amp; 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Eastman Dental Hospitals  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Scarpa","sequence":"additional","affiliation":[{"name":"Department of Statistical Sciences and Department of Mathematics Tullio Levi\u2010Civita University of Padova  Padova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivor","family":"Kwame","sequence":"additional","affiliation":[{"name":"Department of ENT Royal National ENT &amp; Eastman Dental Hospitals  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dalia R.","family":"Ludwig","sequence":"additional","affiliation":[{"name":"Rheumatology Department University College London Hospitals  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"McAdoo","sequence":"additional","affiliation":[{"name":"Department of ENT Imperial College Hospitals  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romana","family":"Kuchai","sequence":"additional","affiliation":[{"name":"Department of ENT Imperial College Hospitals  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Gane","sequence":"additional","affiliation":[{"name":"Department of ENT Royal National ENT &amp; 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