How Does Cocaine Abuse Cause Renal Failure?. David Shure May 26, 2009. Differential Diagnosis. Cocaine induced malignant HTN/ TMA ATN GN Worsening Creat 4/10 = rapid lowering BP. Background. Est: 23 mil Americans have used cocaine Subst abuse cost to US economy: ~144 bil/ year
May 26, 2009
1. A 2/2 deficiency of ADAMTS13 seen in situations where high levels circulating VWF 2/2 endothelial damage. Suggests that in state of marked endothelial damage, ie MHTN, deficiency ADAMTS13 activity may devlp aaro binding to the A2 domain of VWF molecule.
2. High fluid shear rates may result in conformational changes of VWF and promote binding of ADAMTS13, reducing its activity.
3. Degree of EC free Hb 2/2 destruction RBCs is shown to inhibit ADAMTS13 in vitro and may lead to 2/2 deficiency in ADAMTS13.