Levamisole-adulterated cocaine nephrotoxicity: Ultrastructural features

Yi Wei Justin Liu, Sangeeta Mutnuri, Sarah Batool Siddiqui, Geoff Richard Weikle, Olajumoke Oladipo, Niharika Ganti, Robert E. Beach, Marjan Afrouzian

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Objectives: The issue of levamisole-adulterated cocaine is emerging as a rapidly growing public health concern due to an increasing number of reports describing its role in cutaneous vasculitis and agranulocytosis. Of note, levamisole is recognized as a contaminant in 69% of the cocaine used within the United States. Methods: We describe a patient who was a chronic cocaine user and developed systemic vasculitis characterized by polyarthralgia, bullous skin lesions, agranulocytosis, and antineutrophil cytoplasmic antibody-positive rapidly progressive glomerulonephritis. Results: The skin biopsy specimen demonstrated leukocytoclastic vasculitis. The renal biopsy specimen revealed pauci-immune necrotizing and crescentic glomerulonephritis and unusual deposits with medium electron density composed of granules, microspherules, and rare single fibrils on electron microscopy. Conclusions: The electron microscopic features of levamisole-adulterated cocaine toxicity are novel findings that are presented for the first time, to our knowledge, in this report.

Original languageEnglish (US)
Pages (from-to)720-726
Number of pages7
JournalAmerican journal of clinical pathology
Volume145
Issue number5
DOIs
StatePublished - May 1 2016

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Levamisole
Cocaine
Agranulocytosis
Glomerulonephritis
Skin
Electrons
Biopsy
Systemic Vasculitis
Antineutrophil Cytoplasmic Antibodies
Arthralgia
Blister
Vasculitis
Electron Microscopy
Public Health
Kidney

All Science Journal Classification (ASJC) codes

  • Pathology and Forensic Medicine

Cite this

Liu, Y. W. J., Mutnuri, S., Siddiqui, S. B., Weikle, G. R., Oladipo, O., Ganti, N., ... Afrouzian, M. (2016). Levamisole-adulterated cocaine nephrotoxicity: Ultrastructural features. American journal of clinical pathology, 145(5), 720-726. https://doi.org/10.1093/AJCP/AQW029
Liu, Yi Wei Justin ; Mutnuri, Sangeeta ; Siddiqui, Sarah Batool ; Weikle, Geoff Richard ; Oladipo, Olajumoke ; Ganti, Niharika ; Beach, Robert E. ; Afrouzian, Marjan. / Levamisole-adulterated cocaine nephrotoxicity : Ultrastructural features. In: American journal of clinical pathology. 2016 ; Vol. 145, No. 5. pp. 720-726.
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Liu, YWJ, Mutnuri, S, Siddiqui, SB, Weikle, GR, Oladipo, O, Ganti, N, Beach, RE & Afrouzian, M 2016, 'Levamisole-adulterated cocaine nephrotoxicity: Ultrastructural features', American journal of clinical pathology, vol. 145, no. 5, pp. 720-726. https://doi.org/10.1093/AJCP/AQW029

Levamisole-adulterated cocaine nephrotoxicity : Ultrastructural features. / Liu, Yi Wei Justin; Mutnuri, Sangeeta; Siddiqui, Sarah Batool; Weikle, Geoff Richard; Oladipo, Olajumoke; Ganti, Niharika; Beach, Robert E.; Afrouzian, Marjan.

In: American journal of clinical pathology, Vol. 145, No. 5, 01.05.2016, p. 720-726.

Research output: Contribution to journalArticle

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T1 - Levamisole-adulterated cocaine nephrotoxicity

T2 - Ultrastructural features

AU - Liu, Yi Wei Justin

AU - Mutnuri, Sangeeta

AU - Siddiqui, Sarah Batool

AU - Weikle, Geoff Richard

AU - Oladipo, Olajumoke

AU - Ganti, Niharika

AU - Beach, Robert E.

AU - Afrouzian, Marjan

PY - 2016/5/1

Y1 - 2016/5/1

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