Making Crack With Levamisole Vasculitis
Cocaine Levamisole Induced Vasculitis
DESCRIPTIONThe very first patient, an African-american American lady, presented with recurrent necrotizing vasculitis óf her ears (Number ) and was discovered to have got good serology for cytopIasmic antineutrophil cytoplasmic antibódy, individual neutrophil elastase antibody, and anticardiolipin antibody. The 2nd patient has been an African-american American woman with wide-spread necrotizing vasculitis óf her ears, nosé, cheeks, and abóut 30% of her entire body surface region (Body ).
She also acquired necrotizing pneumonia. Serologic results were similar to those of the first situation. She did not enhance despite optimum supportive administration and died. The Table shows the main lab and clinical features of the situations.
Levamisole Vasculitis Treatment
Reports of levamisole-induced vasculopathy (LIV) secondary to use of levamisole-contaminated cocaine largely have been limited to the skin. We report the case of a 35-year-old woman with painful purpuric lesions affecting the cheeks, nose, ears, arms, and legs of several days’ duration. She recently had used crack.
The Mystery of the Tainted Cocaine, Part 1. Levamisole is a bulking agent for crack. The process of making crack involves 'washing' cocaine and filtering out impurities and cutting agents. A patient with previously documented severe vasculitis of the ears and nose returned to the emergency department with worsening vasculitis of her ears. See her first visit. The other is ANCA-associated vasculitis, attributed to the levamisole component that contaminates about 70% of the cocaine. This type of vasculitis may be myeloperoxidase (MPO) and proteinase 3 (PR3) positive, and its main manifestations are typical cutaneous findings, arthralgia, otolaryngologic involvement, and agranulocytosis.
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