致命的勒瓦米索尔相关的多焦点炎性白细胞大脑病变在使用勒瓦米索尔 adulterated 可卡因后
Mathilde Rustin1, Marie Lecronier1, Julien Mayaux1
1Service de Médecine Intensive et Réanimation (Département R3S), Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Pitié-Salpêtrière, Paris, France.
Clinical toxicology (Philadelphia, Pa.)
|July 9, 2025
概括
列瓦米索尔是一种可卡因 adulterant,导致致命的炎症性白脑病变. 这种与可卡因使用相关的疾病带来严重的神经损伤,需要医疗考虑.
科学领域:
- 神经学 神经学
- 毒理学 毒理学 毒理学
- 病理学 病理学 病理学
背景情况:
- 列瓦米索尔经常被检测为非法可卡因中的杂物.
- 与莱瓦米索尔 (Levamisole) 伪造的可卡因与严重的健康后果有关.
研究的目的:
- 报告一个致命的Levamisole相关多焦点炎性白细胞脑病变病例.
- 详细介绍Levamisole暴露患者的临床,成像和组织病理学发现.
主要方法:
- 一个49岁的女性,有可卡因使用史的案例报告.
- 大脑的磁共振成像 (MRI).
- 大脑活检分析.
- 对药物暴露的头发分析.
主要成果:
- 头发分析证实了对levamisole和可卡因的显著暴露.
- 核磁共振扫描显示了广泛的 supratentorial 脑白细胞病变,带有周周结膜和皮层下损伤.
- 脑部活检显示巨细胞透和脱髓化,与急性扩散性脑筋炎类似的过程一致.
结论:
- 与莱瓦米索尔相关的多焦点炎性白内障脑病是使用莱瓦米索尔伪造可卡因的严重并发症.
- 这种情况可能导致不可逆转的神经损伤,包括昏迷和死亡.
- 临床医生应考虑在有可卡因使用史并表现出神经症状的患者中考虑与勒瓦米索尔相关的白细胞脑病变.
相关概念视频
Drug Toxicity: Risk factors
Adverse Drug Reactions (ADRs) are potential complications that arise during pharmacotherapy, influenced by multiple risk factors. Age plays a significant role; both neonates and the elderly are at heightened risk due to their respective immature and diminished metabolic and elimination processes. Gender also impacts ADRs, with females experiencing a 1.5 to 1.7-fold greater risk than males, which may be linked to pharmacokinetic, pharmacodynamic, and hormonal differences. Notably, neonates, the...
Pharmaceutical Poisoning: Treatment Strategies
Treatment strategies for poisoning are a critical aspect of emergency medicine, focusing on preventing the absorption of toxins and enhancing their elimination. When a poisoning incident occurs, the first response is to halt exposure and decontaminate the patient, particularly through gastrointestinal (GI) methods if the poison was ingested.Gastrointestinal Decontamination Techniques:Activated charcoal is the cornerstone of GI decontamination. It works through adsorption, binding the toxin to...
Cryptococcal Meningitis
Cryptococcal meningitis is a life-threatening opportunistic infection predominantly associated with HIV/AIDS, accounting for over 100,000 deaths annually worldwide. However, it also affects individuals with other forms of immunosuppression, including those undergoing immunosuppressive therapy, organ transplant recipients, patients with innate immunodeficiencies, and individuals with hematological disorders. The infection is caused mainly by Cryptococcus neoformans and Cryptococcus gattii,...
Encephalitis l: Introduction
Encephalitis is inflammation of the brain parenchyma, most often due to infections or autoimmune processes. It presents with neuropsychiatric features such as fever, altered mental status, behavioral changes, cognitive dysfunction, seizures, focal deficits, and sometimes autonomic instability. In some cases, the meninges are also involved, resulting in meningoencephalitis.Infectious CausesInfectious encephalitis is most commonly viral but can also result from bacterial, fungal, or parasitic...
Encephalitis ll: Pathophysiology
Encephalitis is inflammation of the brain parenchyma caused by direct viral invasion or immune-mediated mechanisms triggered by infections or tumors. Both processes lead to neuronal injury, disrupted neurotransmission, and diverse neurological symptoms, often with overlapping clinical and pathological features.Autoimmune EncephalitisIn autoimmune encephalitis, antibodies target neuronal antigens on cell surfaces, synapses, or within neurons. A key example is anti-NMDAR encephalitis, which can...
Hepatic Encephalopathy
DefinitionHepatic encephalopathy is a reversible neurologic syndrome that results from advanced liver dysfunction or portosystemic shunting. It leads to disturbances in cognition, behavior, and motor function due to the brain’s exposure to gut-derived toxins that the liver fails to detoxify.EtiologyThis condition develops either in the setting of acute fulminant hepatitis or progressively during chronic liver disease, such as cirrhosis and portal hypertension. Portosystemic shunting—including...


