title: Lupus anticoagulant and ANCA associated thrombotic vasculopathy due to cocaine contaminated with levamisole: a case report and review of the literature.
abstract: A 2010 US report recently detected the presence of levamisole in greater than 77 % of seized cocaine samples. A syndrome of retiform purpura, often involving ears and flanks, with vasculopathy or vasculitis on biopsy, associated with anti-nuclear cytoplasmic antibodies as well as antiphospholipid antibodies, previously associated with therapeutic use of levamisole has now re-emerged, and is associated with cocaine adulterated with levamisole. Patients with this unusual constellation of signs and laboratory findings should be questioned about exposure to cocaine.
authors.affiliation: Department of Internal Medicine, The Reading Hospital and Medical Center, 6th Avenue and Spruce Street, West Reading, PA 19611, USA. gulatishuchi@yahoo.com
authors.forename: Shuchi
authors.initials: S
authors.lastname: Gulati
authors.forename: Anthony A
authors.initials: AA
authors.lastname: Donato
mesh_terms: D000276:Adjuvants, Immunologic / Q000009:adverse effects*; D056648:Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / Q000097:blood* / Q000139:chemically induced / Q000473:pathology; D019268:Antibodies, Antineutrophil Cytoplasmic; D003042:Cocaine / Q000009:adverse effects*; D018765:Dopamine Uptake Inhibitors / Q000009:adverse effects*; D006801:Humans; D007978:Levamisole / Q000009:adverse effects*; D016682:Lupus Coagulation Inhibitor / Q000097:blood*; D008297:Male; D013927:Thrombosis / Q000097:blood* / Q000139:chemically induced / Q000473:pathology
chemical_list: D000276:Adjuvants, Immunologic; D019268:Antibodies, Antineutrophil Cytoplasmic; D018765:Dopamine Uptake Inhibitors; D016682:Lupus Coagulation Inhibitor; D007978:Levamisole; D003042:Cocaine