Hemolytic-uremic syndrome following "crack" cocaine inhalation.

The authors present a patient who experienced cocaine-related thrombotic microangiopathy and patchy renal cortical necrosis, associated with the clinical syndrome of microangiopathic hemolytic anemia, thrombocytopenia and acute renal failure, characteristics of the Hemolytic-Uremic syndrome. The proposed pathogenetic mechanisms include: (1) cocaine-induced vasoconstriction and endothelial damage and (2) procoagulant effects of cocaine.