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