title: Cocaine-induced vasculitis: clinical and immunological spectrum.
abstract: Levamisole-contaminated cocaine has recently been recognized in North America and Europe, and its use is associated with a variety of clinical and autoimmune abnormalities. The clinical characteristic seems to be the presence of a painful purpuric skin rash that predominantly affects the ear lobes and cheeks, often accompanied by systemic manifestations including fever, malaise, arthralgias, myalgias, and laboratory abnormalities, for example leukopenia, neutropenia, positive ANA, ANCA, and phospholipid antibodies. Most of these manifestations can be seen with the use of either drug, especially levamisole. There is no specific therapy, and discontinuation of its use is followed by improvement. Prednisone and immunosuppressive therapy may be needed at times. Further use of the drug is characterized by recurrence of most of the complaints.
authors.affiliation: Rheumatology Section, Department of Internal Medicine, LSU Health Sciences Center, New Orleans, LA 70112-2822, USA. lespin1@lsuhsc.edu
authors.forename: Luis R
authors.initials: LR
authors.lastname: Espinoza
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Perez Alamino
mesh_terms: D000276:Adjuvants, Immunologic / Q000009:adverse effects*; D000380:Agranulocytosis / Q000139:chemically induced / Q000276:immunology; D019268:Antibodies, Antineutrophil Cytoplasmic; D003042:Cocaine / Q000009:adverse effects* / Q000276:immunology; D019970:Cocaine-Related Disorders; D004340:Drug Contamination; D006801:Humans; D007978:Levamisole / Q000009:adverse effects* / Q000276:immunology; D014657:Vasculitis / Q000139:chemically induced* / Q000276:immunology; D014662:Vasoconstrictor Agents / Q000009:adverse effects*
chemical_list: D000276:Adjuvants, Immunologic; D019268:Antibodies, Antineutrophil Cytoplasmic; D014662:Vasoconstrictor Agents; D007978:Levamisole; D003042:Cocaine