Mark Bradford, MD; Brian Rosenberg, MD; Jorge Moreno, MS; Ghinwa Dumyati, MD
Potential Conflicts of Interest: None disclosed.
Bradford M., Rosenberg B., Moreno J., Dumyati G.; Bilateral Necrosis of Earlobes and Cheeks: Another Complication of Cocaine Contaminated With Levamisole. Ann Intern Med. 2010;152:758-759. doi: 10.7326/0003-4819-152-11-201006010-00026
Download citation file:
Published: Ann Intern Med. 2010;152(11):758-759.
Background: Levamisole is a veterinary antihelmintic agent that has also been used as an immunomodulating agent to treat cancer, autoimmune diseases, and the nephrotic syndrome. It has been shown to cause neutropenia and vasculitis (13). The practice of cutting cocaine with levamisole has been increasing since 2005, and in 2009, 70% of cocaine seized at U.S. borders contained levamisole (4). Recent reports (4, 5) have implicated levamisole as a cause of neutropenia in cocaine abusers. Two cocaine abusers with similar cases of neutropenia and vasculitis presented to the University of Rochester Medical Center, New York, within 8 days of each other. We hypothesize that cocaine contaminated with levamisole may cause not only neutropenia but also vasculitis.
to gain full access to the content and tools.
Learn more about subscription options.
Register Now for a free account.
Copyright © 2016 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use
This PDF is available to Subscribers Only