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Cocaine–Levamisole-Associated Vasculopathy Mimicking ANCA-Associated Vasculitis and Presenting With Pulmonary–Renal Syndrome Requiring VV-ECMO Support

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This report examines a rare case of cocaine-levamisole-associated vasculopathy mimicking ANCA-associated vasculitis.
Case report of a 30-year-old woman with symptoms of hemoptysis and renal involvement.
Laboratory evaluation for hematuria, proteinuria, and ANCA positivity.
Interventions included corticosteroids, rituximab, and VV-ECMO support.
Patient presented with dual MPO/PR3 ANCA positivity and necrotizing crescentic glomerulonephritis.
Condition improved post-ECMO with normalized renal function at 18-month follow-up.
Maintained remission despite persistent MPO-ANCA positivity with minimal residual pulmonary issues.

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A case report reveals cocaine-levamisole-associated vasculopathy mimicking ANCA vasculitis, indicating critical early intervention is key.

Vaezi et al. (2026) studied this question.

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A case report reveals cocaine-levamisole-associated vasculopathy mimicking ANCA vasculitis, indicating critical early intervention is key.