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Case Reports
. 2018 Feb 11:2018:7341835.
doi: 10.1155/2018/7341835. eCollection 2018.

A Case of Levamisole-Induced Agranulocytosis

Thamer Kassim  1 , Lakshmi Chintalacheruvu  1 , Osman Bhatty  1 , Mohammad Selim  1 , Osama Diab  1 , Ali Nayfeh  1 , Jayadev Manikkam Umakanthan  2 , Maryam Gbadamosi-Akindele  1
Affiliations
Case Reports

A Case of Levamisole-Induced Agranulocytosis

Thamer Kassim et al. Case Rep Hematol. .

Abstract

A sixty-eight-year-old male with a past medical history of recurrent cocaine use presented to the emergency department with recurrent diarrhea and was found to have a white blood cell (WBC) count of 1.9 × 109/L with agranulocytosis (absolute neutrophil count (ANC) of 95 cell/mm3). At admission, the patient disclosed that he used cocaine earlier during the day, and a urine drug screen tested positive for this. On hospital day one, the patient was found to have a fever with a maximum temperature of 313.6 K. After ruling out other causes and noting the quick turnaround of his neutropenia after four days of cocaine abstinence, the patient's neutropenia was attributed to levamisole-adulterated cocaine.

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Figures

Figure 1
Figure 1
Unremarkable neutrophils in the background of anemia. Absolute leukopenia with absolute neutropenia. Black arrows show a decreased number morphologically.
Figure 2
Figure 2
See this image and copyright information in PMC

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