• Rev Med Interne · Oct 2014

    Case Reports

    [Agranulocytosis and vasculitis in a cocaine addict: levamisole, the hidden culprit].

    • A Lemaignen, T Goulenok, S Kalamarides, A Plat, G Pfau, and B Fantin.
    • Service de médecine interne, hôpital Beaujon, université Paris Diderot, Sorbonne Paris-Cité, AP-HP, 100, boulevard du Général-Leclerc, 92110 Clichy, France.
    • Rev Med Interne. 2014 Oct 1;35(10):676-9.

    IntroductionAdulterants 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 ReportWe 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.ConclusionClinicians should be aware that agranulocytosis or vasculitis or vasculopathy could be related to levamisole toxicity in individuals who use cocaine.Copyright © 2013 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

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