Rheumatology Section, Department of Internal Medicine, LSU Health Sciences Center, New Orleans, LA 70112-2822, USA.
Curr Rheumatol Rep. 2012 Dec;14(6):532-8. doi: 10.1007/s11926-012-0283-1.
Levamisole-contaminated cocaine has recently been recognized in North America and Europe, and its use is associated with a variety of clinical and autoimmune abnormalities. The clinical characteristic seems to be the presence of a painful purpuric skin rash that predominantly affects the ear lobes and cheeks, often accompanied by systemic manifestations including fever, malaise, arthralgias, myalgias, and laboratory abnormalities, for example leukopenia, neutropenia, positive ANA, ANCA, and phospholipid antibodies. Most of these manifestations can be seen with the use of either drug, especially levamisole. There is no specific therapy, and discontinuation of its use is followed by improvement. Prednisone and immunosuppressive therapy may be needed at times. Further use of the drug is characterized by recurrence of most of the complaints.
近年来，在北美和欧洲已经发现了含有左旋咪唑的可卡因，其使用与各种临床和自身免疫异常有关。这种药物的临床特征似乎是出现疼痛性紫癜性皮疹，主要影响耳垂和脸颊，常伴有全身表现，包括发热、不适、关节痛、肌痛和实验室异常，如白细胞减少、中性粒细胞减少、抗核抗体、抗中性粒细胞胞浆抗体和磷脂抗体阳性。这些表现大多可以与两种药物（尤其是左旋咪唑）同时使用时看到。目前没有特效疗法，停药后症状会有所改善。有时需要使用泼尼松和免疫抑制疗法。进一步使用该药物的特点是大多数症状会再次出现。
