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  • Title: [Agranulocytosis and vasculitis in a cocaine addict: levamisole, the hidden culprit].
    Author: Lemaignen A, Goulenok T, Kalamarides S, Plat A, Pfau G, Fantin B.
    Journal: Rev Med Interne; 2014 Oct; 35(10):676-9. PubMed ID: 24290029.
    Abstract:
    INTRODUCTION: Adulterants are compounds added to street drugs to increase profits for the seller. Levamisole, a veterinary antihelminthic agent, has become the most common adulterant of cocaine. The prevalence of levamisole in samples of cocaine is increasing. Levamisole can lead to neutropenia and to a dramatic vasculopathy and even vasculitis of small and medium-size blood vessels. CASE REPORT: We here reported the first French case of levamisole related toxicity, due to cocaine use in a 50-year-old man, revealed by fever and agranulocytosis, high titters of antineutrophil cytoplasmic antibodies (ANCA), anticoagulant and positive Coombs tests. Outcome was slowly favorable with exposition withdrawal. CONCLUSION: Clinicians should be aware that agranulocytosis or vasculitis or vasculopathy could be related to levamisole toxicity in individuals who use cocaine.
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