Levamisole vs. Autoimmune Leukocytoclastic Vasculitis

Levamisole is a veterinary antihelminthic drug that, in the past, was a US Food and Drug Administration-approved drug in humans used to treat various cancers and rheumatoid arthritis because of its immunomodulating effects; however, it is not longer used in the United States since 2000, because of multiple adverse side effects including agranulocytosis and vasculitis. Drug-induced vasculitis is a challenging diagnosis. It is important to recognize that levamisole may not only induce ANCA-associated vasculitis but also other autoimmune markers abnormalities. This case discusses the possibility of levamisole-induced vasculitis and the need to pursue further testing to establish causality in ANCA-associated vasculitis. J Med Cases. 2018;9(1):19-20 doi: https://doi.org/10.14740/jmc2965w