Levamisole-adulterated cocaine nephrotoxicity

Ultrastructural features

Yi Wei Justin Liu, Sangeeta Mutnuri, Sarah Siddiqui, Geoff Richard Weikle, Olajumoke Oladipo, Niharika Ganti, Robert E. Beach, Marjan Afrouzian

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Objectives: The issue of levamisole-adulterated cocaine is emerging as a rapidly growing public health concern due to an increasing number of reports describing its role in cutaneous vasculitis and agranulocytosis. Of note, levamisole is recognized as a contaminant in 69% of the cocaine used within the United States. Methods: We describe a patient who was a chronic cocaine user and developed systemic vasculitis characterized by polyarthralgia, bullous skin lesions, agranulocytosis, and antineutrophil cytoplasmic antibody-positive rapidly progressive glomerulonephritis. Results: The skin biopsy specimen demonstrated leukocytoclastic vasculitis. The renal biopsy specimen revealed pauci-immune necrotizing and crescentic glomerulonephritis and unusual deposits with medium electron density composed of granules, microspherules, and rare single fibrils on electron microscopy. Conclusions: The electron microscopic features of levamisole-adulterated cocaine toxicity are novel findings that are presented for the first time, to our knowledge, in this report.

Original languageEnglish (US)
Pages (from-to)720-726
Number of pages7
JournalAmerican Journal of Clinical Pathology
Volume145
Issue number5
DOIs
StatePublished - May 1 2016

Fingerprint

Levamisole
Cocaine
Agranulocytosis
Glomerulonephritis
Skin
Electrons
Biopsy
Systemic Vasculitis
Antineutrophil Cytoplasmic Antibodies
Arthralgia
Blister
Vasculitis
Electron Microscopy
Public Health
Kidney

Keywords

  • Cocaine
  • Cutaneous vasculitis
  • Electron microscopy
  • Levamisole
  • Pauci-immune

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Levamisole-adulterated cocaine nephrotoxicity : Ultrastructural features. / Liu, Yi Wei Justin; Mutnuri, Sangeeta; Siddiqui, Sarah; Weikle, Geoff Richard; Oladipo, Olajumoke; Ganti, Niharika; Beach, Robert E.; Afrouzian, Marjan.

In: American Journal of Clinical Pathology, Vol. 145, No. 5, 01.05.2016, p. 720-726.

Research output: Contribution to journalArticle

Liu, Yi Wei Justin ; Mutnuri, Sangeeta ; Siddiqui, Sarah ; Weikle, Geoff Richard ; Oladipo, Olajumoke ; Ganti, Niharika ; Beach, Robert E. ; Afrouzian, Marjan. / Levamisole-adulterated cocaine nephrotoxicity : Ultrastructural features. In: American Journal of Clinical Pathology. 2016 ; Vol. 145, No. 5. pp. 720-726.
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