About the Study
In the past few years, cocaine in British Columbia has been found to contain a substance called "levamisole." Levamisole is an animal dewormer and was previously used in humans for treating a variety of health conditions such as rheumatoid arthritis and some cancers [1-4]. Levamisole is no longer available for use in humans or animals in Canada [5]. We don't know why levamisole is added to cocaine [6]. However, we know levamisole can cause a condition called "agranulocytosis." This is when white blood cells, which are important for fighting infection, are dramatically reduced. When this happens a person may develop very serious infections, such as pneumonia, septicaemia (blood infection), skin infections, and some even die. Symptoms of agranulocytosis include fevers, chills, nausea, and vomiting. Through reporting by doctors we are tracking cases in BC. In addition, we have begun a study to answer some specific questions.
Purpose of the Study: Agranulocytosis occurs in a small proportion of people who are smoking crack. We are doing a study to find out more about the condition. Why some people get it and others don't; what happens after people recover; and why some get it more than once.
What we are asking of Study Participants: We are following up patients who have been reported to have agranulocytosis. We will ask participants a few questions and to give a spit sample so we can test for some genetic markers (including HLA-B27). We would also like participants to invite 3 friends who also use drugs to take part in the study as well.
Goal of this Study: to help doctors better treat patients after exposure to cocaine tainted with levamisole and understand how levamisole affects the health of cocaine users.
Resources:
References
[1] Drew, S., Carter, B., Nathanson, D., Terasaki, P. Levamisole-associated neutropenia and autoimmune granulocytotoxins. Ann. Rheum. Dis. (1980) 39: 59-63.
[2] Barbano, G., Ginevri, F., Ghiggeri, G., Gusmano, R. Disseminated autoimmune disease during levamisole treatment of nephrotic syndrome. Pediatr Nephrol (1999) 13: 602-603.
[3] Macdonald JS. Adjuvant therapy of colon cancer. CA Cancer J Clin (1999) 49: 202-19.
[4] Verma S., Quirt I., McCready D., Bak K., Charette M., Iscoe N. Systematic review of systemic adjuvant therapy for patients at high risk for recurrent melanoma. Cancer (2006) 106: 1431-42
[5] Wiens, M., Son W., Ross, C., Hayden, M., Carleton, B.. CMAJ (2010) 182: 57-59.
[6] Raymon, L., Isenschmid, D. The Possible Role of Levamisole in Illicit Cocaine Preparations J. Ana. Tox. (2009) 33: 620-2.
Last Updated: November 29, 2010