title: Old drug new trick: levamisole-adulterated cocaine causing acute kidney injury.
abstract: Levamisole is an agent previously used in humans and later withdrawn from the US drug market due to concerns of agranulocytosis.It is currently used as an adulterating agent in cocaine, bringing to light toxicities typically manifested by vasculitis and skin necrosis.We report a case of a 36-year-old crack cocaine user who presented with a purpuric rash on her face and limbs. Levamisole-induced vasculitis was suspected, and she therefore underwent an extensive work-up. In addition to these findings, she also presented with acute kidney injury of unknown etiology, which was later attributed to levamisoleadulterated cocaine.
authors.affiliation: John H. Stroger, Jr Hospital of Cook County, Department of Pharmacy, Chicago, IL, USA. Electronic address: abeer.ammar1@gmail.com.
authors.forename: Abeer T
authors.initials: AT
authors.lastname: Ammar
authors.affiliation: John H. Stroger, Jr Hospital of Cook County, Department of Emergency Medicine, Chicago, IL, USA. Electronic address: mlivak@cookcountyhhs.org.
authors.forename: Mark
authors.initials: M
authors.lastname: Livak
authors.affiliation: John H. Stroger, Jr Hospital of Cook County, Department of Pharmacy, Chicago, IL, USA; John H. Stroger, Jr Hospital of Cook County, Department of Emergency Medicine, Chicago, IL, USA. Electronic address: jwitsil@cookcountyhhs.org.
authors.forename: Joanne C
authors.initials: JC
authors.lastname: Witsil
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced*; D000328:Adult; D019970:Cocaine-Related Disorders / Q000150:complications; D016578:Crack Cocaine / Q000009:adverse effects*; D004340:Drug Contamination; D005260:Female; D006801:Humans; D007978:Levamisole / Q000009:adverse effects*
chemical_list: D016578:Crack Cocaine; D007978:Levamisole