Work

Delayed Diagnosis of Amphetamine-Associated CNS Vasculitis Presenting as a Mass Lesion: Case Report and Literature Review

Year: 2025

Type: article

Abstract: A 41-year-old man with no prior medical history presented with subacute confusion and left-sided weakness. Routine laboratory test results were normal, but toxicologic screening detected cannabinoids and N-methylphenethylamine (amphetamine). Magnetic resonance imaging showed a heterogeneously enhancing right frontotemporal mass concerning for neoplasm. He had 2 nondiagnostic biopsies and continued to decline despite high-dose steroids. A right temporal lobectomy ultimately led to the diagnosis of central nervous system (CNS) vasculitis, attributed to amphetamine use. The patient died and CNS vasculitis was confirmed on autopsy. This case illustrates that CNS vasculitis may present as a mass lesion, which may raise cognitive biases and delay diagnosis.

Source: Annals of Internal Medicine Clinical Cases

DOI: 10.7326/aimcc.2023.1137

Authors: Heitor Cabral Frade, Muhammad Qasim, Akhil Shivaprasad, Gregory N. Fuller, Adel K. El-Naggar, Ashwin Viswanathan, Ivo W. Tremont-Lukats, Nazanin K. Majd

Institutions: The University of Texas Medical Branch at Galveston, SIU Medicine, The University of Texas MD Anderson Cancer Center, Baylor College of Medicine, Houston Methodist

Language: English

Topic: Vasculitis and related conditions

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4407149390

FWCI: 0.591

Cites: 24

Cited by: 1

Related to: 10