Agranulocytosis and vasculitis in a cocaine addict: Levamisole, the hidden culprit

作者：Lemaignen A; Goulenok T^*; Kalamarides S; Plat A; Pfau G; Fantin B

来源：Revue de Medecine Interne, 2014, 35(10): 676-679.

DOI：10.1016/j.revmed.2013.10.337

• Cocaine
• Levamisole
• Vasculopathy
• Neutropenia

Introduction. - Adulterants are compounds added to street drugs to increase profits for the seller. Levamisole, a veterinary antihelminthic agent, has become the most common adulterant of cocaine. The prevalence of levamisole in samples of cocaine is increasing. Levamisole can lead to neutropenia and to a dramatic vasculopathy and even vasculitis of small and medium-size blood vessels.
Case report. - We here reported the first French case of levamisole related toxicity, due to cocaine use in a 50-year-old man, revealed by fever and agranulocytosis, high titters of anti-neutrophil cytoplasmic antibodies (ANCA), anticoagulant and positive Coombs tests. Outcome was slowly favorable with exposition withdrawal.
Conclusion. - Clinicians should be aware that agranulocytosis or vasculitis or vasculopathy could be related to levamisole toxicity in individuals who use cocaine.

• 出版日期2014-10