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Cocaine- and Levamisole-Induced Vasculitis: Defining the Spectrum of Autoimmune Manifestations.
J Clin Med
August 2024
Rheumatology Unit, Department of Medicine DIMED, University of Padua, 35128 Padua, Italy.
Article Synopsis
- Drug-induced vasculitis is a common type that mimics ANCA vasculitis, often linked to cocaine and levamisole use.
- These substances lead to various autoimmune conditions, including cocaine-induced midline destructive lesions and forms of vasculitis, creating a complex overlap in symptoms.
- The exact mechanisms of how cocaine causes these autoimmune issues remain unclear, complicating diagnosis and treatment, especially when there's no suspicion of drug abuse.
Granulomatosis with polyangiitis or its mimic? A case report.
J Int Med Res
April 2024
Department of Rheumatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
Article Synopsis
- Differentiating between granulomatosis with polyangiitis (GPA) and cocaine-induced midline destructive lesion (CIMDL) is challenging due to similar histopathological features and ANCA profiles.
- A young woman was initially diagnosed with GPA, but further tests revealed she actually had CIMDL from cocaine use, prompting a reassessment to "cocaine-induced GPA mimic."
- To properly diagnose similar cases, urine tests for cocaine and HNE ELISA are recommended, and the primary treatment is to avoid cocaine use.
Levamisole-Adulterated Cocaine-Induced Thrombotic Vasculopathy With Negative Serology.
Cureus
July 2022
Internal Medicine, Geisinger Health System, Wilkes-Barre, USA.
Substance abuse is an important public health issue in the United States. The prevalence of cocaine use is wide, and it is noted to be adulterated with a substance called levamisole, which can increase the bulk and possibly potentiate cocaine's euphoric effect. Literature shows that levamisole-induced vasculopathy has a strong association with antineutrophil cytoplasmic antibodies (ANCA) antibodies.
View Article and Find Full Text PDFGranuloma Faciale in Woman With Levamisole-Induced Vasculitis.
Cutis
April 2022
Dr. Gibson is from the School of Medicine, University of Texas Health Science Center, San Antonio. Drs. Shiu and Kowalewski are from the South Texas Veterans Health Care Services, San Antonio.
Late Onset of ANCA Vasculitis as a Side Effect of Levamisole Treatment in Nephrotic Syndrome.
Medicina (Kaunas)
May 2022
Néphrologie Pédiatrique, Centre de Référence du Syndrome Néphrotique Idiopathique de l'Enfant et de l'Adulte, Hôpital Necker-Enfants Malades, AP-HP, 75015 Paris, France.
Levamisole is effectively used in steroid-dependent nephrotic syndrome and the more frequent side effects reported are cytopenia and liver enzymes alterations. Several studies have demonstrated that this drug can induce high titers of circulating perinuclear antineutrophil cytoplasmic autoantibodies (ANCA) and vasculitis, most of them occurring in the case of prolonged use. A four-year-old boy that was affected with steroid-dependent nephrotic syndrome was treated with Levamisole as a steroid-sparing agent at a dose of 2 mg/kg/48 h.
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