由掺有左旋咪唑的可卡因引起的白细胞破碎性血管炎。
Leukocytoclastic Vasculitis Induced by Cocaine Adulterated with Levamisole.
作者信息
Barbotti Alberto, Gheorghiu Alina Cristiana, Fusi-Schmidhauser Tanja, Grazioli-Gauthier Lorenzo
机构信息
Department of Internal Medicine, Ospedale Regionale di Lugano EOC, Lugano, Switzerland.
出版信息
Eur J Case Rep Intern Med. 2022 Jul 25;9(7):003468. doi: 10.12890/2022_003468. eCollection 2022.
UNLABELLED
Leukocytoclastic vasculitis is a cutaneous, small-vessel vasculitis. In 50% of cases the aetiology is idiopathic but it can be linked to drugs, infections, autoimmune disorders and various types of cancer. Levamisole is used as an adulterant in cocaine and heroin and has been associated with the development of leukocytoclastic vasculitis. We describe an atypical presentation of a patient with levamisole-induced leukocytoclastic vasculitis who presented with diffuse skin abscesses and a purpuric rash of the upper and lower limbs.
LEARNING POINTS
In patients with intravenous drug consumption and a clinical presentation of leukocytoclastic vasculitis, it is important to consider levamisole as a possible contributing factor.Negative screening for MPO-ANCA and PR3-ANCA antibodies does not exclude levamisole-induced leukocytoclastic vasculitis.Diagnostic criteria for leukocytoclastic vasculitis induced by levamisole have not yet been established.
未标注
白细胞破碎性血管炎是一种皮肤小血管炎。50%的病例病因不明，但可能与药物、感染、自身免疫性疾病及各类癌症有关。左旋咪唑被用作可卡因和海洛因的掺杂物，与白细胞破碎性血管炎的发生有关。我们描述了一名左旋咪唑诱导的白细胞破碎性血管炎患者的非典型表现，该患者出现弥漫性皮肤脓肿及上下肢紫癜性皮疹。
学习要点
对于有静脉吸毒史且临床表现为白细胞破碎性血管炎的患者，重要的是要考虑左旋咪唑可能是一个致病因素。髓过氧化物酶抗中性粒细胞胞浆抗体（MPO-ANCA）和蛋白酶3抗中性粒细胞胞浆抗体（PR3-ANCA）抗体筛查阴性不能排除左旋咪唑诱导的白细胞破碎性血管炎。左旋咪唑诱导的白细胞破碎性血管炎的诊断标准尚未确立。
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