Elevated C-reactive Protein and Role of Steroids in Cocaine-associated Levamisole-induced Vasculitis

Swetha Ann Alexander; Vinay Mathew Thomas; Jacqueline A Savage

doi:10.7759/cureus.7597

Elevated C-reactive Protein and Role of Steroids in Cocaine-associated Levamisole-induced Vasculitis

Cureus. 2020 Apr 9;12(4):e7597. doi: 10.7759/cureus.7597.

Authors

Swetha Ann Alexander¹, Vinay Mathew Thomas¹, Jacqueline A Savage²

Affiliations

¹ Internal Medicine, University of Connecticut, Farmington, USA.
² Medicine, Hartford Hospital, Hartford, USA.

Abstract

Levamisole is a common contaminant in cocaine and has led to the emergence of an entity known as levamisole-induced vasculitis (LIV). There is no consensus on the management of this condition. We describe a patient who presented with acute on chronic LIV who was treated with pulse dose steroids. We aim to discuss the diagnosis and current management options for LIV. We have compared seven case reports that have measured C-reactive protein (CRP) and compared the CRP levels, site involved, dose, and mode of steroid administration. We postulate that elevated CRP may warrant steroid therapy over conservative management and could lead to a possible decreased hospital stay.

Keywords: cocaine; cocaine levamisole-induced vascuiltis; crp; levamisole; levamisole-induced vasculitis; steroid; vasculitis.

Publication types

Case Reports