title: COKE LIVe: recurrent vasculitis secondary to cocaine contaminated with levamisole.
abstract: Levamisole-induced vasculitis (LIV) is becoming an increasingly common entity secondary to both rising cocaine use in the UK and high levels of adulteration of cocaine with various contaminants. We report the first documented case of LIV secondary to adulterated cocaine in Ireland, which presented as a 6-year history of recurrent vasculitis of unknown aetiology. Classically, LIV is diagnosed by a combination of positive ANCA serology and agranulocytosis however, given the frequency of cocaine use, we urge acute physicians to consider the diagnosis in cases of typical retiform (angulated) purpura in association with a history of cocaine use.
authors.affiliation: BA MB Bch BAO, MRCPI.
authors.forename: Vicki
authors.initials: V
authors.lastname: Sandys
authors.affiliation: BSc, MB ChB, BAO, MRCPI.
authors.forename: Shanti
authors.initials: S
authors.lastname: Mahabir
authors.affiliation: BSc Human Nutrition, MB Bch BAO, MRCPI, Dist Pharmaceutical Medicine, MSc Pharmaceutical Science.
authors.forename: Declan
authors.initials: D
authors.lastname: Byrne
authors.affiliation: MB BCh BAO LRCP&SI MRCPI.
authors.forename: Bairbre
authors.initials: B
authors.lastname: Wynne
mesh_terms: D000328:Adult; D003042:Cocaine / Q000009:adverse effects*; D019970:Cocaine-Related Disorders / Q000150:complications; D004340:Drug Contamination; D005260:Female; D006801:Humans; D007494:Ireland; D007978:Levamisole / Q000009:adverse effects*; D008297:Male; D012008:Recurrence; D018570:Risk Assessment; D014657:Vasculitis / Q000139:chemically induced* / Q000503:physiopathology
chemical_list: D007978:Levamisole; D003042:Cocaine