![]() These drugs have been known to be associated with a range of renal pathologies, from reversible acute kidney injuries to debilitating irreversible conditions like renal infarction. Every year thousands of Americans visit the emergency departments all over the country with illicit drug related complaints. The United States is faced with an unprecedented epidemic of drug abuse. Extreme state of volume depletion because of recurrent vomiting and extreme dehydration along with immobilization can be the precipitating factor. As shown in Tables 1&2, several reports have documented specific renal pathologies mainly acute tubular necrosis (ATN) and acute Bath Salts Heroin Amphetamine Cocaine Cocaine & Levamisole CPD Opioids # of Patients In Case Reports Several models used to assess risk of AKI due to concern for collinearity between Heroin, cocaine and alcohol * univariate analysis, ** multivariate analysis **CRP-C reactive protein, Z lactated dehydrogenase, # Creatinine phosphokinase interstitial nephritis (AIN) with some accompanied clinically by rhabdomyolysis. Synthetic cannabinoids are known to cause AKI but the exact mechanism is still unclear. We highlight our diagnostic and therapeutic considerations, including hair testing for definitive proof of exposure. The proper diagnostic strategy and therapy is still controversial. Cocaine–levamisole-induced vasculitis poses a great clinical challenge. Importantly, at time of the relapse, the patient became positive for both myeloperoxidase-antineutrophil cytoplasmic antibody (ANCA) and proteinase 3-ANCA. She recovered through cocaine abstinence, but re-exposure resulted in a severe relapse with glomerulonephritis. The definitive diagnosis was made using hair testing for toxins. Symptoms included ulcerating skin lesions, arthralgia and myalgia, and the occurrence of an ileal intussusception. We present the case of a 42-year-old woman suffering from vasculitis due to levamisole-contaminated cocaine, who persistently denied substance abuse. The diagnosis can be challenging, especially when substance abuse is uncertain. Levamisole-contaminated cocaine can induce severe systemic vasculitis. ![]()
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