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The cocaine trail: levamisole-induced leukocytoclastic vasculitis in a cocaine user
Omar Metwally1, Massihullah Hamidi, Leilani Townsend
1Department of Internal Medicine, University of Michigan Health System, 3301 Taubman Center (SPC 5382), 1500 E. Medical Center Drive, Ann Arbor, MI 48109, USA. metwally@med.umich.edu
Abstract:
Two million Americans use cocaine on a regular basis. Sixty-nine percent of cocaine in the United States is adulterated with levamisole, a veterinary antihelminthic drug. In 2008, the first cases of levamisole-induced agranulocytosis and vasculopathy associated with adulterated cocaine were reported in the southwestern United States. Since then, reports of levamisole-associated toxicity have become increasingly common. The authors present the case of a 47-year-old woman from Michigan with purpuric lesions likely secondary to levamisole-induced leukocytoclastic vasculitis.
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