Cocaine-levamisole vasculitis, with cutaneous, joint and gastrointestinal manifestations

Case report


Authors

DOI:

https://doi.org/10.22517/25395203.24982

Keywords:

substance-related disorders, vasculitis, cocaine, levamisol

Abstract

Levamisole is an antiparasitic agent for veterinary use that is currently being used to increase the volume and potency of cocaine and thus obtain more profits in its commercialization. The mixture of these two substances can cause in the organism the cocaine-levamisole syndrome, which is characterized by cocaine-like lesions such as the involvement of the septal cartilage and perforation of the nasal septum, cutaneous vasculitis of small vessels as well as a specific vasculitic involvement. of auricular pavilions and nasal cartilage that can progress to necrosis and even ulceration associated with agranulocytosis, arthralgias and rarely glomerulonephritis. In this case, a vasculitis syndrome associated with cocaine-levamisole is described, with mainly cutaneous and joint manifestations, as well as gastrointestinal. The patient presented an adequate response with steroids, but before recurrence required additional management with cyclophosphamide for total control of symptoms.

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Author Biographies

José Julián Aristizábal-Hernández, MD, MSc, Clínica Universitaria Bolivariana. Universidad Pontificia Bolivariana

Médico.

Especialista en Toxicología Clínica.

Ciencias Clínicas.

 

María Paulina Villa-Saldarriaga, MD, Universidad Pontificia Bolivariana

Médica.

Residente de Medicina Interna.

 

María Carolina Rave-Aguirre, MD, Hospital Santa Margarita, Copacabana, Antioquia

Médica.

Coordinadora de urgencias, Médica del programa atención primaria en salud. Médica de vigilancia epidemiológica. Médica PIC, alcaldía de Copacabana.

Juliana Ceballos-Giraldo, MD, Hospital La María

Médica.

Ana Mercedes Vanegas-Torres, MD, Hospital Marco Fidel Suarez, Bello, Antioquia.

Médica.

Miguel Antonio Mesa-Navas, MD, Clínica SOMER, Rionegro, Antioquia. Clínica del Rosario sede del Tesoro, Medellín, Antioquia. Unidad de Investigación en Reumatologia SURA

Médico. 

Especialista en Medicina Interna

Especialista en Reumatología.

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Published

2022-10-30 — Updated on 2022-12-27

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How to Cite

Aristizábal-Hernández, J. J., Villa-Saldarriaga, M. P., Rave-Aguirre, M. C., Ceballos-Giraldo, J., Vanegas-Torres, A. M., & Mesa-Navas, M. A. (2022). Cocaine-levamisole vasculitis, with cutaneous, joint and gastrointestinal manifestations: Case report. Revista Médica De Risaralda, 28(2). https://doi.org/10.22517/25395203.24982 (Original work published October 30, 2022)

Issue

Vol. 28 No. 2 (2022): Julio- Diciembre 2022

Section

Case report

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