ArticleMedicine2014
Pauci-immune glomerulonephritis in individuals with disease associated with levamisole-adulterated cocaine: a series of 4 cases.
Article in Medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 48 citations in OpenAlex.
- Systematic review of nephrotoxicity of drugs of abuse, 2005-2016.BMC nephrology · 2017Pooled it
- Drug-Induced Renal Vasculitis: Etiology, Pathogenesis, Clinical Manifestations, and Therapeutic Approaches-A Narrative Review.Health science reports · 2025Article
- Pulmonary-Renal Syndrome from Levamisole-Adulterated Cocaine-Induced Antineutrophil Cytoplasmic Antibody (ANCA)-Associated Vasculitis: A Systematic Review.Pharmaceuticals (Basel, Switzerland) · 2023Review
- Pulmonary Renal Syndrome: Perilous Presentation in Pediatrics.Indian pediatrics · 2022Article
- Cocaine/Levamisole-Induced, Skin-Limited ANCA-Associated Vasculitis with Pyoderma Gangrenosum-like Presentation.Dermatopathology (Basel, Switzerland) · 2022Article
- Cocaine-induced ANCA-associated renal disease: a case-based review.Rheumatology international · 2019Review
- Spectrum of acute kidney injury associated with cocaine use: report of three cases.BMC nephrology · 2019Article
- Systemic sclerosis induced by the use of cocaine: is there an association?Rheumatology international · 2019Review
- Multiple cutaneous and mucosal lesions in a patient with cocaine-levamisole-induced vasculopathy syndrome.Proceedings (Baylor University. Medical Center) · 2019Article
- Unusual case of levamisole-induced dual-positive ANCA vasculitis and crescentic glomerulonephritis.BMJ case reports · 2018Article
- Levamisole adulterated cocaine associated ANCA vasculitis: review of literature and update on pathogenesis.Journal of community hospital internal medicine perspectives · 2018Review
- Necrotizing and crescentic glomerulonephritis with membranous nephropathy in a patient exposed to levamisole-adulterated cocaine.Clinical kidney journal · 2016Article
- Hydralazine-induced pauci-immune glomerulonephritis: intriguing case series with misleading diagnoses.Journal of community hospital internal medicine perspectives · 2016Review
- Cocaine/levamisole-induced systemic vasculitis with retiform purpura and pauci-immune glomerulonephritis.Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologica · 2016Article
- Membranous glomerulonephritis and cellular crescents induced by levamisole-adulterated cocaine abuse: a case report.Annals of translational medicine · 2015Article
- Levamisole-contaminated cocaine: a hairy affair.BMJ case reports · 2015Article
- Levamisole-adulterated cocaine: a case of retiform purpura, cutaneous necrosis and neutropenia.BMJ case reports · 2015Article
- Pathologic manifestations of levamisole-adulterated cocaine exposure.Diagnostic pathology · 2015Review
- Necrotizing ANCA-Positive Glomerulonephritis Secondary to Culture-Negative Endocarditis.Case reports in nephrology · 2015Article
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Authors and funding
7 authors at 1 institution in 1 country.
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Abstract
Exposure to levamisole-adulterated cocaine can induce a distinct clinical syndrome characterized by retiform purpura and/or agranulocytosis accompanied by an unusual constellation of serologic abnormalities including antiphospholipid antibodies, lupus anticoagulants, and very high titers of antineutrophil cytoplasmic antibodies. Two recent case reports suggest that levamisole-adulterated cocaine may also lead to renal disease in the form of pauci-immune glomerulonephritis. To explore this possibility, we reviewed cases of pauci-immune glomerulonephritis between 2010 and 2012 at an inner city safety net hospital where the prevalence of levamisole in the cocaine supply is known to be high. We identified 3 female patients and 1 male patient who had biopsy-proven pauci-immune glomerulonephritis, used cocaine, and had serologic abnormalities characteristic of levamisole-induced autoimmunity. Each also had some other form of clinical disease known to be associated with levamisole, either neutropenia or cutaneous manifestations. One patient had diffuse alveolar hemorrhage. Three of the 4 patients were treated with short courses of prednisone and cyclophosphamide, 2 of whom experienced stable long-term improvement in their renal function despite ongoing cocaine use. The remaining 2 patients developed end-stage renal disease and became dialysis-dependent. This report supports emerging concern of more wide spread organ toxicity associated with the use of levamisole-adulterated cocaine.
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