ANCA Associated Vasculitis Secondary to Levamisole-Adultered Cocaine with Associated Membranous Nephropathy: A Case Series

作者：Collister David^*; Sathianathan Christie; Ryz Krista; Karpinski Martin; Bernstein Keevin; Gibson Ian W

来源：American Journal of Nephrology, 2017, 45(3): 209-216.

DOI：10.1159/000456553

• Levamisole-adultered cocaine
• ANCA associated vasculitis
• Membranous nephropathy

Background: Cocaine is a risk factor for acute kidney injury and chronic kidney disease with progression to end-stage renal disease. Levamisole is an adulterant that is added to cocaine to enhance its euphoric effects. Levamisole-adulterated cocaine (LAC) is associated with the distinct clinical syndromes of agranulocytosis, leukocytoclastic vasculitis, cocaine-induced midline destructive lesions (CIMDL), and ANCA-associated vasculitis (AAV) with pauci-immune necrotizing glomerulonephritis. Methods: We reviewed all cases of AAV secondary to LAC at our institution. Results: We report 3 cases of AAV secondary to LAC and associated membranous nephropathy (MN). The first and second cases are concurrent AAV secondary to LAC and associated MN while the third case involves the development of MN after AAV secondary to LAC. Conclusions: Clinicians should be aware of this novel association of LAC with MN.

• 出版日期2017