[Thrombotic vasculopathy probably associated with cocaine contaminated with levamisole: report of 2 cases]

Rev Med Inst Mex Seguro Soc. 2015 Jan-Feb;53(1):98-101.
[Article in Spanish]

Abstract

The vasculities are complex diseases. Their cutaneous manifestations are very important and often mirror several pathologies. Cocaine use has been related to both, vasculitis and thrombotic vasculopathy and pseudovasculitis. A new syndrome has been described in association with its adulteration with levamisole. It can be very serious, leading patients to death. This is relevant as levamisole-adultered cocaine seems to be increasingly offered to consumers. Our goal is to report the first two cases in Mexico, which faces an important raise in cocaine use, emphasizing that a high suspicion based on certain characteristics allows for early recognition and adequate treatment.

Las vasculitis son enfermedades complejas con manifestaciones cutáneas importantes que pueden traducir diversas patologías. El uso de cocaína está relacionado con casos tanto de vasculitis y vasculopatía trombótica, como de pseudovasculitis. Recientemente se ha descrito una condición peculiar asociada a su forma adulterada con levamisol, la cual puede ser incluso mortal, y cuya frecuencia va en aumento. Nuestro objetivo es reportar los primeros dos casos de alta sospecha en México, que enfrenta un incremento en el consumo de cocaína, enfatizando en que ciertas características y la realización de determinados estudios permiten la identificación temprana y el tratamiento adecuado de esta condición.

Keywords: Cocaine; Levamisole; Neutropenia; Thrombotic vasculopathy; Vasculitis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Capillaries / drug effects
  • Cocaine / chemistry*
  • Drug Contamination*
  • Humans
  • Illicit Drugs / chemistry*
  • Illicit Drugs / toxicity*
  • Levamisole / toxicity*
  • Male
  • Mexico
  • Skin / blood supply
  • Thrombosis / chemically induced*
  • Thrombosis / diagnosis
  • Vasculitis / chemically induced*
  • Vasculitis / diagnosis

Substances

  • Illicit Drugs
  • Levamisole
  • Cocaine