Levamisole in cocaine causes agranulocytosis and neutropenia: Skin necrosis, renal issues, and/or opportunistic infections
- Cases of agranulocytosis, neutropenia, and vasculitis related to cocaine use continue to be seen in toronto
- These illnesses are due to an adulterant, levamisole, a chemical compound used to treat worms in animals, rather than from the cocaine itself. Individuals in Toronto, and across North America, have developed immune system suppression after using cocaine.
- A large percentage of cocaine entering North America continues to be cut with levamisole.
- Although cases have been found across age and gender, female cases have been more frequent.
Clinical Signs and Symptoms
Diagnostics and Testing
- Urine toxicology can be sent simultaneously looking for cocaine and levamisole. However, levamisole has a short detection “window” in urine (specimen should be collected within 24 h of last use).
- Some people having severe reactions to levamisole may be positive for HLA-B27 genotype.