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LevamisoleCocaine Induced Systemic Vasculitis and Immune Complex Glomerulonephritis
Joint Authors
Garg, Lohit
Gupta, Sagar
Swami, Abhishek
Zhang, Ping L.
Source
Issue
Vol. 2015, Issue 2015 (31 Dec. 2015), pp.1-5, 5 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2015-07-28
Country of Publication
Egypt
No. of Pages
5
Main Subjects
Abstract EN
Levamisole is an antihelminthic and immunomodulator medication that was banned by the USFDA in 1998.
It has been increasingly used to adulterate cocaine due to its psychotropic effects and morphological properties.
Adverse reactions including cutaneous vasculitis, thrombocytopenia, and agranulocytosis have been well described.
Despite systemic vasculitis in this setting, renal involvement is uncommon.
We report here a case of ANCA positive systemic vasculitis with biopsy proven immune complex mediated glomerulonephritis likely secondary to levamisole/cocaine.
A 40-year-old Caucasian male with no past medical history presented with 3-week history of fatigue, skin rash, joint pains, painful oral lesions, oliguria, hematuria, worsening dyspnea on exertion, and progressive lower extremity edema.
He had a history of regular tobacco and cocaine use.
Lab testing revealed severe anemia, marked azotemia, deranged electrolytes, and 4.7 gm proteinuria.
Rheumatologic testing revealed hypocomplementemia, borderline ANA, myeloperoxidase antibody, and positive atypical p-ANCA.
Infectious and other autoimmune workup was negative.
Kidney biopsy was consistent with immune mediated glomerulonephritis and showed mesangial proliferation and immune complex deposition consisting of IgG, IgM, and complement.
High dose corticosteroids and discontinuing cocaine use resulted in marked improvement in rash, mucocutaneous lesions, and arthritis.
There was no renal recovery and he remained hemodialysis dependent.
American Psychological Association (APA)
Garg, Lohit& Gupta, Sagar& Swami, Abhishek& Zhang, Ping L.. 2015. LevamisoleCocaine Induced Systemic Vasculitis and Immune Complex Glomerulonephritis. Case Reports in Nephrology،Vol. 2015, no. 2015, pp.1-5.
https://search.emarefa.net/detail/BIM-1058962
Modern Language Association (MLA)
Garg, Lohit…[et al.]. LevamisoleCocaine Induced Systemic Vasculitis and Immune Complex Glomerulonephritis. Case Reports in Nephrology No. 2015 (2015), pp.1-5.
https://search.emarefa.net/detail/BIM-1058962
American Medical Association (AMA)
Garg, Lohit& Gupta, Sagar& Swami, Abhishek& Zhang, Ping L.. LevamisoleCocaine Induced Systemic Vasculitis and Immune Complex Glomerulonephritis. Case Reports in Nephrology. 2015. Vol. 2015, no. 2015, pp.1-5.
https://search.emarefa.net/detail/BIM-1058962
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1058962