described a series of 30 cases of levamisole-induced ANCA vasculitis. This disease may compromise multiple organs and systems. Discussionĭuring recent years the number of cases of vasculitis associated with levamisole-adulterated cocaine consumption has increased. As well as insisting on the cessation of consumption treatment with prednisolone continued, with good clinical response and a rise in haemoglobin, although there was only partial improvement in renal function, so that additional monthly boli of cyclophosphamide were added. During a subsequent evaluation perforation of the nasal septum was observed and the patient confirmed frequent consumption of cocaine. Fibrobroncoscoy confirmed alveolar haemorrhage (haemosiderophages 40%) and ruled out infection. Proteins 75 mg/leukocytes 0-5/CAP/erythrocytes 21-50/HPF (70% crenated)Īnti-glomerular basement membrane IgG (0-20 units)ĭiffuse endocapilar glomerulonephritis was observed in a renal biopsy, with immune complex deposits and tubulointerstitial nephritis. Urine analysis (cells per high power field (HPF) Anti-Sm, anti-DNA and anti-basement glomerular membrane antibodies were negative. Additional studies found multiple antibody positivity: ANCA (antimyeloperoxidase and antiproteinase-3), ANA, anti-Ro, anti-La, lupus anticoagulant, rheumatoid factor and anticardiolipin IgM. At first the diagnosis of systemic lupus erythmatosus (SLE) was considered due to the finding of hypocomplementemia.

He was diagnosed pulmonary-renal syndrome and treatment commenced with high doses of steroids and blood cell transfusion. He had severe anaemia, renal dysfunction and mixed opacities in both pulmonary fields ( Fig. He was normotensive, with no tachycardia or fever.

Mucocutaneous pallor, hypoxemia and rale in the base of the lungs. He was admitted for one week due to general discomfort, pallor, a dry cough, thoracic pain and dyspnea. Clinical observationĪ 34 year-old male with a history of reactive arthritis and daily marihuana consumption. Vasculitis caused by levamisole is highly heterogeneous in terms of clinical symptoms and analytical results, hindering diagnosis. The adulteration of cocaine with substances such as levamisole leads to the appearance of additional medical problems. Cocaine consumption is still a public health problem.

Levamisole cocaine symptoms