COKE LIVe: recurrent vasculitis secondary to cocaine contaminated with levamisole.

Vicki Sandys, Shanti Mahabir, Declan Byrne, Bairbre Wynne

Journal: Acute medicine 2018;15(4):206-208

PMID: 28112289

Abstract

Levamisole-induced vasculitis (LIV) is becoming an increasingly common entity secondary to both rising cocaine use in the UK and high levels of adulteration of cocaine with various contaminants. We report the first documented case of LIV secondary to adulterated cocaine in Ireland, which presented as a 6-year history of recurrent vasculitis of unknown aetiology. Classically, LIV is diagnosed by a combination of positive ANCA serology and agranulocytosis however, given the frequency of cocaine use, we urge acute physicians to consider the diagnosis in cases of typical retiform (angulated) purpura in association with a history of cocaine use.

Address: BA MB Bch BAO, MRCPI.; BSc, MB ChB, BAO, MRCPI.; BSc Human Nutrition, MB Bch BAO, MRCPI, Dist Pharmaceutical Medicine, MSc Pharmaceutical Science.; MB BCh BAO LRCP&SI MRCPI.

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Medical:

https://medlineplus.gov/vasculitis.html

MeSH Terms: Adult, Cocaine, Cocaine-Related Disorders, Drug Contamination, Female, Humans, Ireland, Levamisole, Male, Recurrence, Risk Assessment, Vasculitis