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J Med Toxicol. 2015 Mar;11(1):124-8. doi: 10.1007/s13181-014-0422-3.

Susac-like syndrome in a chronic cocaine abuser: could levamisole play a role?

Author information

1
Louvain Centre for Toxicology and Applied Pharmacology, Cliniques St-Luc, Université catholique de Louvain, Brussels, Belgium, philippe.hantson@uclouvain.be.

Abstract

INTRODUCTION:

Toxic leukoencephalopathy is a possible but rare complication of chronic cocaine abuse. The role of adulterants, mainly levamisole, is still debated.

CASE REPORT:

We describe an atypical case of fatal leukoencephalopathy mimicking Susac syndrome in a 22-year-old man who was chronically abusing cannabis and cocaine. Exposure to levamisole as adulterant to cocaine was proven by hair analysis. Despite cessation of exposure to cocaine and aggressive immunosuppressive therapy, the patient remained in a minimally conscious state until death.

DISCUSSION:

Susac syndrome is a rare entity, and its etiology is not yet fully elucidated. The toxic etiologies have been poorly investigated to date. Further observations are required to determine if cocaine and/or adulterants might play a significant role.

PMID:
25142038
PMCID:
PMC4371041
DOI:
10.1007/s13181-014-0422-3
[Indexed for MEDLINE]
Free PMC Article

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