Levamisole Induced Autoimmunity

Tello, Nina; Alej, Jorge; Mateos-Parra, ro; Alej,; Díaz-Borjon, ro

doi:10.4172/2167-7921.1000187

Cited by 1 publication

(2 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There are limited reports of levamisole-induced AAV in the absence of concomitant cocaine exposure [ 5 , 6 , 7 , 35 , 42 ], and none, to our knowledge, report pulmonary or renal vasculitis secondary to isolated levamisole exposure. The exact pathogenesis of LAC-induced AAV is unclear, but several potential mechanisms have been described.…”

Section: Discussionmentioning

confidence: 99%

“…The therapeutic use of levamisole in humans has been discontinued in many countries due to severe adverse effects, including agranulocytosis, seizures, skin necrosis, and vasculitis [ 2 , 3 , 4 ]. A systemic, antineutrophil cytoplasmic antibody (ANCA)-positive vasculitis has been reported in patients on therapeutic doses of levamisole [ 5 , 6 , 7 ]. Levamisole remains widely available as a veterinary medicine and is commonly used as a cutting agent for cocaine to increase its potency and weight [ 3 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Pulmonary-Renal Syndrome from Levamisole-Adulterated Cocaine-Induced Antineutrophil Cytoplasmic Antibody (ANCA)-Associated Vasculitis: A Systematic Review

et al. 2023

View full text Add to dashboard Cite

Levamisole is an anti-helminthic drug with immunomodulatory properties that is added to cocaine to increase its potency and weight. Levamisole-adulterated cocaine (LAC) may cause an antineutrophil cytoplasmic antibody (ANCA)-associated systemic small vessel vasculitis (AAV). We aimed to characterize the phenotype of persons developing pulmonary-renal syndrome (PRS) in LAC-induced AAV and summarize its treatment and outcomes. Pubmed and Web of Science were searched (until September 2022). Reports that described co-existing diffuse alveolar hemorrhage and glomerulonephritis in an adult (age ≥ 18) with confirmed or suspected LAC exposure were included. Reports, demographics, clinical and serologic features, treatment and outcome characteristics were extracted. Of the 280 records identified, eight met the inclusion criteria, including eight unique cases. Persons were aged 22–58 years, and 50% were women. Cutaneous involvement occurred in only half of the cases. Other associated vasculitis findings and serologies were heterogeneous. All patients received immunosuppression with steroids, with cyclophosphamide and rituximab commonly added. We concluded that PRS could occur from LAC-induced AAV. Distinguishing LAC-induced AAV from primary AAV is challenging as clinical and serologic presentations overlap. Asking about cocaine use is requisite in persons presenting with PRS to guide diagnosis and appropriately counsel on cocaine cessation in conjunction with immunosuppression as treatment.

show abstract