Levamisole
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Leukocytoclastic vasculitis: case report A 61-year-old man developed leukocytoclastic vasculitis following levamisole adulterated cocaine [route, dosage and duration of treatment to reaction onset not stated]. The man, who had a history of levamisole adulterated cocaine use, was admitted to hospital with two days history of diffuse necrotic and purpuric lesions, acute kidney injury and respiratory distress. Laboratory findings revealed positive anti-neutrophil cytoplasmic antibodies, anti-myeloperoxidase antibodies, lupus anticoagulant and low complement levels. He underwent a bronchoscopy, and the broncho-alveolar lavage was found to be haemorrhagic. Skin biopsy showed leukocytoclastic vasculitis and confirmed the diagnosis of levamisole-induced leukocytoclastic vasculitis. He also developed acute confusion secondary to vasculitis. The man started receiving supportive therapy including wound care, respiratory support and haemodialysis. Due to the multiple organ involvement, he started receiving plasma exchange and unspecified steroids. He showed improvement and was discharged from ICU, but was haemodialysis dependent. Orfanos S, et al. Multi-organ failure secondary to levamisole induced vasculitis. American Journal of Respiratory and Critical Care Medicine 199: (plus poster) abstr. A3103, 803446048 No. 9, May 2019. Available from: URL: https://doi.org/10.1164/ajrccm-conference.2019.199.1_MeetingAbstracts.A3103 [abstract]
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Reactions 18 Jan 2020 No. 1787
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