Leukocytoclastic vasculitis in an intravenous heroin abuser

A young intravenous substance-abusing woman developed a leukocytoclastic vasculitis manifested by pericarditis, cardiomyopathy, pulmonary interstitial fibrosis, an inflammatory pleural effusion, and severe hemolytic anemia which have responded to steroid therapy. Her disease was characterized serologically by very high titers of rheumatoid factor and circulating immune complexes. It is suggested that the use of intravenous narcotics may have been causal in establishing a small vessel angiitis mediated by circulating immune complexes.