Hipopotasemia y consumo excesivo de bebidas con cola

Elexpuru, Eneko Ceciaga; Agara, Miguel María Echegaray; Calderón, José Ignacio Berasategui; Pérez, José Félix Capellán

doi:10.1016/j.medcli.2010.03.012

Cited by 2 publications

(1 citation statement)

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“…In Europe, levamisole has been detected in seized cocaine samples in the U. K., Italy, and Spain. During the second half of 2009, surveillance program results suggest widespread cocaine consumption in Spain, with levamisole adulteration ranging from 3% to 20% [4]. …”

Section: Introductionmentioning

confidence: 99%

ANCA-positive vasculitis induced by levamisole-adulterated cocaine and nephrotic syndrome: The kidney as an unusual target

et al. 2013

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Patient: Male, 36Final Diagnosis: Levamisole-induced vasculopathySymptoms: Purpuric skin lesionsMedication: LevamisoleClinical Procedure: —Specialty: Internal MedicineObjective:Unusual clinical courseBackground:Levamisole has been detected in seized cocaine samples and a levamisole-induced vasculopathy (LIV) has been described, mainly focused on skin.Case Report: A 36-year-old Caucasian man with history of antibodies to hepatitis C infection (negative hepatitis C virus RNA and negative HIV serology), smoking, and intravenous use of cocaine and brown heroin, presented to the hospital with purpuric skin lesions on extremities and earlobes. One month before the current presentation, a skin punch biopsy of one of these lesions was performed, showing histopathologic findings suggestive of mixed cryoglobulinemia. Laboratory testing revealed leukopenia, renal failure, and nephrotic syndrome. Antimyeloperoxidase antineutrophil cytoplasmic antibodies (MPO-ANCA) were positive. The previous skin punch biopsy was revised and demonstrated pathologic findings consistent with leukocytoclastic vasculitis. An analysis of a cocaine sample for personal use, provided by the patient, was performed using mass spectrometry-gas chromatography and levamisole was detected. Three boluses of intravenous methylprednisolone were administered, followed by oral prednisone 1 mg/Kg per day. Skin lesions and renal function improved.Conclusions:To our knowledge, this is the first report of nephrotic syndrome induced by levamisole-adulterated cocaine, proven by cocaine sample toxicology. Lack of renal biopsy is a limitation of this report.

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Section: Introductionmentioning

confidence: 99%