Levamisole/Cocaine Induced Systemic Vasculitis and Immune Complex Glomerulonephritis

Figure 1

(a) Masson trichrome stain (100x) revealed severe interstitial fibrosis, thickened arterioles, and mild proliferation of glomeruli. (b) PAS stain (600x) showed mild mesangial proliferation and segmental sclerosis. No extra capillary crescent or necrosis was identified. Six of 10 glomeruli were globally sclerosed. (c) IF showed 2-3+ IgG and C3 deposit mainly in mesangium and also along the capillary loops. (d) Electron microscopy showed intramembranous and subepithelial electron dense deposits with occasional subendothelial and mesangial deposits. There were segmental foot process effacement and focal mesangial interposition.

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