左旋咪唑掺杂可卡因继发抗中性粒细胞胞浆抗体相关性血管炎合并膜性肾病：病例系列

ANCA Associated Vasculitis Secondary to Levamisole-Adultered Cocaine with Associated Membranous Nephropathy: A Case Series.

作者信息

Collister David, Sathianathan Christie, Ryz Krista, Karpinski Martin, Bernstein Keevin, Gibson Ian W

机构信息

Department of Medicine, University of Manitoba, Winnipeg, MB, Canada.

出版信息

Am J Nephrol. 2017;45(3):209-216. doi: 10.1159/000456553. Epub 2017 Jan 28.

DOI:10.1159/000456553

PMID:28132051

Abstract

BACKGROUND

Cocaine is a risk factor for acute kidney injury and chronic kidney disease with progression to end-stage renal disease. Levamisole is an adulterant that is added to cocaine to enhance its euphoric effects. Levamisole-adulterated cocaine (LAC) is associated with the distinct clinical syndromes of agranulocytosis, leukocytoclastic vasculitis, cocaine-induced midline destructive lesions (CIMDL), and ANCA-associated vasculitis (AAV) with pauci-immune necrotizing glomerulonephritis.

METHODS

We reviewed all cases of AAV secondary to LAC at our institution.

RESULTS

We report 3 cases of AAV secondary to LAC and associated membranous nephropathy (MN). The first and second cases are concurrent AAV secondary to LAC and associated MN while the third case involves the development of MN after AAV secondary to LAC.

CONCLUSIONS

Clinicians should be aware of this novel association of LAC with MN.

摘要

背景

可卡因是急性肾损伤和慢性肾脏病进展至终末期肾病的危险因素。左旋咪唑是一种添加到可卡因中以增强其欣快效果的掺杂物。掺有左旋咪唑的可卡因（LAC）与粒细胞缺乏症、白细胞破碎性血管炎、可卡因诱导的中线破坏性病变（CIMDL）以及伴有寡免疫坏死性肾小球肾炎的抗中性粒细胞胞浆抗体相关性血管炎（AAV）等独特临床综合征相关。