Key result
Hair analysis links levamisole and cocaine exposure to ANCA-positive vasculitis.
Why the study?
Levamisole-induced vasculitis is well characterised in cocaine abusers, but the causal role of levamisole is not established due to its short half-life in serum and urine.
Case Report (n=1)
Hair sample analysis can confirm exposure to levamisole in cocaine users presenting with ANCA-positive vasculitis, overcoming the limitation of its short half-life in serum and urine.
May aid causality assessment via hair testing in ANCA vasculitis; leaves open validation before broader clinical or research adoption.
Levamisole-induced vasculitis is a well-characterised antineutrophil cytoplasm antibodies (ANCA)-positive vasculitis in cocaine abuser patients. However, due to the short half-life of levamisole in serum and urine, the causal role of levamisole is not established. Here we report the detection of both levamisole and cocaine in hair samples of a patient who presented with an ANCA-positive vasculitis. The higher concentration of levamisole in proximal sample of the hair confirms that the patient abused of cocaine added with levamisole in the days preceding the development of skin lesions. Although a direct causative role has not been established, our report strongly suggests that levamisole may have triggered vasculitis in this case.
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Lazareth et al. (2012) conducted a case report in ANCA-positive vasculitis (n=1). Levamisole-adulterated cocaine was evaluated on Detection of levamisole and cocaine in hair samples. Detection of levamisole and cocaine in hair samples confirmed recent exposure, strongly suggesting levamisole triggered ANCA-positive vasculitis in this patient.
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