Friday, September 16, 2011

Levamisole toxicity

Today's amuse-bouche was a case of a levamisole-related cutaneous vasculitis syndrome. A few quick points: 

  • Recent trend in cocaine being adulterated by levamisole, 
    • An anti-helminth agent in the 1960s first identified as a cocaine adulterant in the USA in 2003 
    •  Now found in majority of cocaine seized at US borders, common in Canada also
    • Proposed that levamisole potentiates the psychotropic effects of cocaine, and that producers intentionally add it during the cocaine manufacturing process 
  • Associated with a cutaneous vasculitic syndrome 
    • Purpuric lesions and/or cutaneous necrosis 
    • Involves the ears in ~50% of reported cases 
    • Lab associations: neutropenia + pANCA and + cANCA
More in a case-series review here.

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