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Cocaine and Levamisole Induced Vasculitis
Levamisole adulterated cocaine is a rare cause of anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis. It is increasingly diagnosed because of raised awareness; however, it is still underdiagnosed in part because of its rarity and patients not reporting cocaine use. Here we report a ca...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8439268/ https://www.ncbi.nlm.nih.gov/pubmed/34548986 http://dx.doi.org/10.7759/cureus.17192 |
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author | Gill, Harpreet Trinh, Dylan Anderson, Danyon J Li, Nathan Madenberg, Devin |
author_facet | Gill, Harpreet Trinh, Dylan Anderson, Danyon J Li, Nathan Madenberg, Devin |
author_sort | Gill, Harpreet |
collection | PubMed |
description | Levamisole adulterated cocaine is a rare cause of anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis. It is increasingly diagnosed because of raised awareness; however, it is still underdiagnosed in part because of its rarity and patients not reporting cocaine use. Here we report a case of levamisole-induced vasculitis. We present a 48-year-old non-Hispanic white male with a past medical history significant for Crohn’s Disease and pneumonia who presented with acute bilateral ear pain and rash. His urinary drug screen was positive, which prompted suspicion of contamination and potential levamisole adulterated cocaine-associated vasculitis. A punch biopsy showed evidence of leukocytoclastic vasculitis and multiple fibrin thrombi further supporting contamination with levamisole. We believe this case highlights the importance of using patient history in guiding diagnostic testing in the setting of acute vasculitis. Once the history of illicit substance use was confirmed, our differential diagnosis and considerations for treatment significantly changed. |
format | Online Article Text |
id | pubmed-8439268 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-84392682021-09-20 Cocaine and Levamisole Induced Vasculitis Gill, Harpreet Trinh, Dylan Anderson, Danyon J Li, Nathan Madenberg, Devin Cureus Emergency Medicine Levamisole adulterated cocaine is a rare cause of anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis. It is increasingly diagnosed because of raised awareness; however, it is still underdiagnosed in part because of its rarity and patients not reporting cocaine use. Here we report a case of levamisole-induced vasculitis. We present a 48-year-old non-Hispanic white male with a past medical history significant for Crohn’s Disease and pneumonia who presented with acute bilateral ear pain and rash. His urinary drug screen was positive, which prompted suspicion of contamination and potential levamisole adulterated cocaine-associated vasculitis. A punch biopsy showed evidence of leukocytoclastic vasculitis and multiple fibrin thrombi further supporting contamination with levamisole. We believe this case highlights the importance of using patient history in guiding diagnostic testing in the setting of acute vasculitis. Once the history of illicit substance use was confirmed, our differential diagnosis and considerations for treatment significantly changed. Cureus 2021-08-15 /pmc/articles/PMC8439268/ /pubmed/34548986 http://dx.doi.org/10.7759/cureus.17192 Text en Copyright © 2021, Gill et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Emergency Medicine Gill, Harpreet Trinh, Dylan Anderson, Danyon J Li, Nathan Madenberg, Devin Cocaine and Levamisole Induced Vasculitis |
title | Cocaine and Levamisole Induced Vasculitis |
title_full | Cocaine and Levamisole Induced Vasculitis |
title_fullStr | Cocaine and Levamisole Induced Vasculitis |
title_full_unstemmed | Cocaine and Levamisole Induced Vasculitis |
title_short | Cocaine and Levamisole Induced Vasculitis |
title_sort | cocaine and levamisole induced vasculitis |
topic | Emergency Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8439268/ https://www.ncbi.nlm.nih.gov/pubmed/34548986 http://dx.doi.org/10.7759/cureus.17192 |
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