Lupus anticoagulant and ANCA associated thrombotic vasculopathy due to cocaine contaminated with levamisole: a case report and review of the literature

J Thromb Thrombolysis. 2012 Jul;34(1):7-10. doi: 10.1007/s11239-012-0711-0.

Abstract

A 2010 US report recently detected the presence of levamisole in greater than 77 % of seized cocaine samples. A syndrome of retiform purpura, often involving ears and flanks, with vasculopathy or vasculitis on biopsy, associated with anti-nuclear cytoplasmic antibodies as well as antiphospholipid antibodies, previously associated with therapeutic use of levamisole has now re-emerged, and is associated with cocaine adulterated with levamisole. Patients with this unusual constellation of signs and laboratory findings should be questioned about exposure to cocaine.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adjuvants, Immunologic / adverse effects*
  • Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / blood*
  • Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / chemically induced
  • Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / pathology
  • Antibodies, Antineutrophil Cytoplasmic
  • Cocaine / adverse effects*
  • Dopamine Uptake Inhibitors / adverse effects*
  • Humans
  • Levamisole / adverse effects*
  • Lupus Coagulation Inhibitor / blood*
  • Male
  • Thrombosis / blood*
  • Thrombosis / chemically induced
  • Thrombosis / pathology

Substances

  • Adjuvants, Immunologic
  • Antibodies, Antineutrophil Cytoplasmic
  • Dopamine Uptake Inhibitors
  • Lupus Coagulation Inhibitor
  • Levamisole
  • Cocaine