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Case Reports in Rheumatology
Volume 2012, Article ID 982361, 4 pages
Case Report

Cocaine Induced Vasculitis: Have We Found a Culprit?

1Department of Internal Medicine, San Juan City Hospital, San Juan, PR 00928, USA
2Department of Internal Medicine, VA Caribbean Healthcare System, San Juan, PR 00921, USA

Received 18 October 2012; Accepted 5 December 2012

Academic Editors: G. S. Alarcon, A. Giusti, and M. Soy

Copyright © 2012 Alfredo Sánchez-Cruz et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Cocaine abuse is relatively common in our society. To enhance profitability and acceptability of the product, it is not uncommon for illicit drugs to undergo several processes. The Drug Enforcement Agency (DEA) has reported that seventy percent (70%) of cocaine seized at USA borders has been adulterated with levamisole, previously used as chemotherapeutic and immunomodulator for several conditions. Among the side effects of levamisole-adulterated cocaine, necrotizing vasculitis is the more dramatic. We report three cases of necrotizing vasculitis associated with antineutrophils cytoplasmic antibodies (ANCAs) positivity, linked to the use of cocaine. To our knowledge, these are the first cases of cocaine induced vasculitis reported in the Caribbean.