Cocaine-induced vasculitis: is this a new trend?
Miraida Reneé García Pérez1, Vanessa L Ortiz-González1, Maria Betancourt1
1Department of Internal Medicine, San Juan City Hospital.
Open Access Rheumatology : Research and Reviews
|October 3, 2013
Summary
Cocaine adulterated with levamisole can cause a rare condition called levamisole-induced vasculitis. This case highlights a Puerto Rican patient with this severe necrotizing vasculitis.
Area of Science:
- Toxicology
- Dermatology
- Rheumatology
Background:
- Cocaine adulterated with levamisole is linked to a rare complication: cocaine-induced vasculitis.
- Levamisole, previously used in chemotherapy, can cause necrotizing vasculitis.
Observation:
- A 43-year-old female presented with hematuria, fever, fatigue, and skin lesions including ulcers and purpuric plaques.
- Physical examination revealed knee ulcers and bilateral ear lesions.
- Laboratory tests confirmed cocaine use and showed leucopenia, microcytic anemia, proteinuria, and hematuria.
Findings:
- The patient tested positive for perinuclear anti-neutrophil cytoplasmic antibody, cytoplasmic anti-neutrophil cytoplasmic antibody, antinuclear antibody, and elastase specificity.
- Complement levels were decreased, and punch biopsy confirmed necrotizing vasculitis with superficial thrombosis.
- Anticardiolipin and lupus anticoagulant antibodies were negative.
Implications:
- This case underscores the association between levamisole-adulterated cocaine and severe vasculitis.
- Early recognition and diagnosis are crucial for managing this condition.
- Further research into the mechanisms and treatment of levamisole-induced vasculitis is warranted.
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