ReviewDiagnostic pathology2015
Pathologic manifestations of levamisole-adulterated cocaine exposure.
Review in Diagnostic pathology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
24 citing papers in PubMed, 69 citations in OpenAlex.
- Article
- The Utility of Myeloperoxidase Immunostaining to Characterize Immune Deposits in Patients With Crescentic Glomerulonephritis.Kidney international reports · 2025Article
- Two case reports of rare cocaine-associated dermatoses: Pyoderma gangrenosum and linear IgA bullous dermatosis.SAGE open medical case reports · 2025Article
- Cocaine-induced Vasculitis: Uncommon Manifestations in the Lower Extremities - A Case Report.Journal of community hospital internal medicine perspectives · 2025Article
- Cocaine- and Levamisole-Induced Vasculitis: Defining the Spectrum of Autoimmune Manifestations.Journal of clinical medicine · 2024Review
- Kidney Biopsy Proven Thrombotic Microangiopathy Induced by Methamphetamine.Internal medicine (Tokyo, Japan) · 2024Article
- ANCA-associated vasculitis presenting with isolated neurological manifestations in a patient with cocaine abuse: a case report and literature review.Clinical rheumatology · 2024Review
- [Cocaine-induced vasculitis and mimics of vasculitis].Zeitschrift fur Rheumatologie · 2023Review
- Pulmonary-Renal Syndrome from Levamisole-Adulterated Cocaine-Induced Antineutrophil Cytoplasmic Antibody (ANCA)-Associated Vasculitis: A Systematic Review.Pharmaceuticals (Basel, Switzerland) · 2023Review
- Levamisole-induced and COVID-19-induced retiform purpura: two overlapping, emerging clinical syndromes.Archives of dermatological research · 2023Review
- Cocaine-induced granulomatosis with polyangiitis-an under-recognized condition.Rheumatology advances in practice · 2023Article
- Perspectives of people in Philadelphia who use fentanyl/heroin adulterated with the animal tranquilizer xylazine; Making a case for xylazine test strips.Drug and alcohol dependence reports · 2022Article
- Article
- Double Suicide Due to the Ingestion of Levamisole-Adulterated Cocaine: Case Report and Review of the Literature.Academic forensic pathology · 2022Article
- Use of levamisole-adulterated cocaine is associated with increased load of white matter lesions.Journal of psychiatry & neuroscience : JPN · 2021Article
- Anti-Opioid Antibodies in Individuals Using Chronic Opioid Therapy for Lower Back Pain.ACS pharmacology & translational science · 2020Article
- A fatal case of levamisole induced bone marrow failure.BMJ case reports · 2019Article
- DARK Classics in Chemical Neuroscience: Aminorex Analogues.ACS chemical neuroscience · 2018Review
- Levamisole adulterated cocaine associated ANCA vasculitis: review of literature and update on pathogenesis.Journal of community hospital internal medicine perspectives · 2018Review
- Levamisole: A High Performance Cutting Agent.Academic forensic pathology · 2017Review
Corrections and comments
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Rheumatic manifestations of cocaine have been well described, but more recently, a dramatic increase in the levamisole-adulterated cocaine supply in the United States has disclosed unique pathologic consequences that are distinct from pure cocaine use. Most notably, patients show skin lesions and renal dysfunction in the setting of extremely high perinuclear anti-neutrophil cytoplasmic antibodies (p-ANCA). Unexpectedly, antibodies to myeloperoxidase, the typical target of p-ANCA, are relatively low if at all present. This discrepancy is due to the fact that p-ANCA seen in association with levamisole-adulterated cocaine exposure is often directed against atypical p-ANCA-associated antigens within the neutrophil granules such as human neutrophil elastase, lactoferrin, and cathepsin G. Biopsies of the skin lesions reveal leukocytoclastic vasculitis often involving both superficial and deep dermal vessels. Renal injury most typically manifests as crescentic and necrotizing pauci-immune glomerulonephritis. In this review, the manifestations of levamisole-adulterated cocaine-induced vasculitis are discussed with an emphasis on the typical histomorphologic findings seen on biopsy. VIRTUAL SLIDES: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1764738711370019 .
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