levamisole / Generic mfg. - LARVOL DELTA

CPC01 Eosinophilic cellulitis in the setting of cocaine use. (PubMed, Br J Dermatol) - "Oral prednisolone (0.5 mg kg-1 per day) was commenced, with rapid improvement noted within days. In this case it is also possible that the clinical findings were triggered by a contaminated batch of cocaine, as levamisole-adulterated cocaine can cause autoimmunity syndromes such as drug-induced ANCA. This dangerous recreational drug initiates inflammation through formation of neutrophil extracellular traps, which culminates in pronounced autoimmune responses including ANCA production."

Journal • Cardiovascular • Dermatology • Eosinophilia • Hypotension • Immunology • Infectious Disease • Inflammation • Otorhinolaryngology • Pneumonia • Respiratory Diseases • Sinusitis • CRP

Activity of antifilarial drugs on microfilaremia in the treatment of loiasis: a systematic review. (PubMed, Parasit Vectors) - "Antifilarial drug efficacy against L. loa microfilaremia varies by dosage and treatment duration, with IVM and DEC demonstrating rapid, high efficacy but presenting safety concerns for hypermicrofilaremic individuals. ALB and MBZ show efficacy with extended treatment but are slower acting. Further research is needed to optimize treatment regimens and assess clinical outcomes beyond microfilaremia reduction."

Journal • Review

Effect of injectable antioxidants on redox profile after Peste des petits ruminants (PPR) vaccination in Naïve goat kids. (PubMed, Trop Anim Health Prod) - No abstract available

Journal

Seroconversion following varicella vaccination in children and adolescents with nephrotic syndrome. (PubMed, Pediatr Nephrol) - "To conclude, this study demonstrates that varicella vaccination confers seroprotection in approximately two-thirds of children with NS, with low rates of breakthrough varicella."

Journal • Glomerulonephritis • Nephrology • Renal Disease • Varicella Zoster

Vasculopathy and vasculitis associated with levamisole-adulterated cocaine: a systematic review. (PubMed, J Autoimmun) - "Levamisole-induced vasculopathy/vasculitis is a distinctive skin-predominant condition with characteristic clinical and serological features. Withdrawal of levamisole is the cornerstone of management."

Journal • Glomerulonephritis • Hematological Disorders • Leukopenia • Lupus Nephritis • Nephrology • Renal Disease • Vasculitis • MPO

Prevalence and types of anti-neutrophil cytoplasmic antibodies in patients with nephrotic syndrome treated with levamisole. (PubMed, Pediatr Nephrol) - "A significant proportion of patients with steroid-sensitive nephrotic syndrome receiving > 6-months' therapy with levamisole show positive ANCA, with antigen specificity against myeloperoxidase, neutrophil elastase and/or proteinase-3. The risk was higher in girls and lower in those receiving concurrent therapy with prednisolone in the past 6-months. Stopping levamisole therapy was associated with resolution of ANCA."

Journal • Glomerulonephritis • Hematological Disorders • Leukopenia • Nephrology • Pediatrics • Renal Disease • Vasculitis • ELANE • MPO

Hybridization, high genetic diversity, and molecular evidence of drug resistance to albendazole and levamisole in Haemonchus populations infecting goats in Thailand. (PubMed, BMC Vet Res) - "This study revealed the hybrid form of H. contortus and H. placei in goats, high genetic diversity of H. contortus populations, and the presence of albendazole and levamisole resistance. The growing challenge of drug resistance and hybridization in Haemonchus populations demonstrates the urgent need for regulated drug use and the implementation of sustainable management practices."

Journal • Infectious Disease

Chronic Retiform Purpura in the Setting of Levamisole-Tainted Heroin Use: A Diagnostic Challenge. (PubMed, Int J Dermatol) - No abstract available

Journal • Vasculitis

Is routine cocaine testing justified in patients with septal perforation? (PubMed, Rhinology) - "Cocaine inhibits catecholamine reuptake, leading to vasoconstriction, tissue necrosis, and, ultimately, septal damage. Furthermore, the adulterant levamisole, present in up to 80% of seized cocaine in Germany, is a known trigger for vasculitis, compounding this effect (1,2)."

Journal • Vasculitis

Optimized Rabbit Antithymocyte Globulin Protocol Plus Sequential Cyclosporine and Levamisole Regimen for Newly Diagnosed Severe Aplastic Anemia: A Single-Arm, Single-Centre, Prospective, Phase 2 Trial (ASH 2023) - P2 | "Front-line sequential optimized rATG protocol with CSA and LMS regimen resulted in encouraging long-term survival. Future randomized studies should evaluate the optimized IST regimen in the treatment of patients with SAA."

Clinical • P2 data • Preclinical • Acute Myelogenous Leukemia • Anemia • Aplastic Anemia • Cerebral Hemorrhage • Hematological Disorders • Hematological Malignancies • Hepatology • Infectious Disease • Leukemia • Oncology

Computational and experimental investigations of novel 1,3-disubstituted thioureas as the dual inhibitor of b-TNAP and b-CAII enzyme for Cancer treatment. (PubMed, Bioorg Chem) - "The derivative exhibited roughly 20 to 25 times more inhibition compared to the standards used, levamisole and acetazolamide, which were selected due to their known inhibitory effects against b-TNAP and b-CA-II, respectively. Furthermore, the synthesized compounds obtained positive results from ADMET predictions confirming their accrued pharmacokinetic profiles and drug-likeness properties. This suggests the synthesized compounds can be considered potential lead compounds to synthesize more potential compounds for the treatment of cancer and its associated malignancies."

Journal • Oncology

ANCA-Associated Glomerulonephritis Due to Levamisole-Adulterated Cocaine Use (KIDNEY WEEK 2025) - "Therapeutic management involves induction therapy with glucocorticoids and cyclophosphamide, and long-term maintenance with rituximab or azathioprine to prevent relapse. Counseling on cocaine cessation is essential to avoid recurrence. The increasing prevalence of levamisole-adulterated cocaine presents diagnostic and therapeutic challenges, necessitating a high index of suspicion for ANCA-associated glomerulonephritis in patients with unexplained renal dysfunction and cocaine use."

Clinical • Acute Kidney Injury • Anemia • Chronic Kidney Disease • Gastroenterology • Glomerulonephritis • Hematological Disorders • Hepatology • Immunology • Inflammation • Lupus Nephritis • Nephrology • Renal Disease • Vasculitis • MPO

AI-Assisted Time-to-Event Projection: A Case Study and Broader Potential (ISPOR-EU 2025) - "The use of iterative prompting to a LLM to obtain information on these parameters was tested in a study requiring overall survival with levamisole-based treatment for stage B/C colon cancer. The LLM was able to identify the relevant study, review it, provide a detailed summary of the risk profile of the study population, and "best estimates of the median and mean years these patients could expect to survive without access to the newer treatments"... With structured prompting and provision of some contextual information, LLMs can facilitate the inclusion of clinical input in time-to-event projection analyses. This could be advanced further using APIs to integrate the AI capabilities into agentic tools that streamline the analytic process. The well-known risks of hallucinations and errors remain a concern in such applications, compelling human review and active involvement of clinical experts."

Case study • Clinical • Colon Cancer • Colorectal Cancer • Solid Tumor

Drug- and vaccine induced ANCA-associated vasculitis: An overview. (PubMed, Autoimmun Rev) - "Whereas causality is difficult to prove and rechallenges are considered unethical, pathophysiological mechanisms suggesting causality have been demonstrated for drugs such as hydralazine, propylthiouracil, levamisole, and immune checkpoint inhibitors. In general, however, the long-term prognosis of drug-induced ANCA-associated vasculitis is more favorable compared to the prognosis of idiopathic ANCA-associated vasculitis. Physicians that are treating patients with vasculitis should be aware of the possible role of drugs and vaccines in the development ANCA-associated vasculitis."

Journal • Review • ANCA Vasculitis • Oncology • Vasculitis

Novel LC-MS/MS strategies combining low-temperature partition extraction and DLLME for sensitive levamisole determination in fish. (PubMed, Food Chem) - "The LTPE method was successfully applied in the analysis of real samples to evaluate levamisole residues in fish. To the best of our knowledge, this is the first study to combine LTPE and DLLME, representing a promising advance in sensitive and selective methods for routine monitoring of levamisole and potentially other VDRs in food-producing animals."

Journal

Levamisole Contaminated Cocaine as Cause of a self-induced Agranulocytosis: A Case Report (DGHO 2025) - "Our case highlights a potential differential diagnosis in young people with agranulocytosis. Especially as recent reports estimate that 2.5 Million EU citizens between the ages of 15-34 use cocaine. This case also adds to the limited literature on Levamisole-induced agranulocytosis and emphasizes the importance of a good medical history."

Case report • Clinical • Agranulocytosis • Anemia • Aplastic Anemia • Febrile Neutropenia • Glomerulonephritis • Granulocytopenia • Hematological Disorders • Hematological Malignancies • Infectious Disease • Leukemia • Lupus Nephritis • Lymphoma • Nephrology • Neutropenia

Using the new guideline for diagnosing anthelmintic resistance of gastrointestinal nematodes to different chemical components in sheep in the Rio Grande do Norte State, Brazil. (PubMed, Rev Bras Parasitol Vet) - "The faecal egg count reduction test (FECRT) was carried out to evaluate the pre- and post-treatment of anthelmintics, including albendazole, closantel, disophenol, ivermectin, levamisole, monepantel, moxidectin and trichlorfon, using the new classification criteria to analyze the results of an FECRT, which defined three possible classifications: susceptible, resistant and inconclusive...Two drugs (trichlorfon and monepantel) proved to be highly effective in treating gastrointestinal nematodes, presenting CI varying from 98 to 100% and 97 to 100%, respectively. Gastrointestinal nematodes from sheep raised in the in the Rio Grande do Norte State, Brazil are susceptible to the active principles trichlorfon and monepantel."

Journal

Cocaine- and Levamisole-Induced Vasculitis (CLIV). (PubMed, Cureus) - "Treatment most often involved corticosteroids, with severe cases requiring rituximab, cyclophosphamide, or plasmapheresis. Prognosis improved with early diagnosis and cessation of exposure. Recognition of CLIV in cocaine users presenting with ANCA-positive vasculitis is essential for early intervention and improved outcomes."

Journal • Review • ANCA Vasculitis • Glomerulonephritis • Hematological Disorders • Lupus Nephritis • Nephrology • Vasculitis

AN UNEXPECTED CULPRIT OF ANCA-ASSOCIATED VASCULITIS WITH PULMONARY-RENAL SYNDROME (CHEST 2025) - "Rarely, ANCA-associated vasculitis can be drug-induced; most frequently by minocycline, propylthiouracil, hydralazine, and levamisole-adulterated cocaine...Treatment consists of high-dose steroids and immunosuppression with rituximab or cyclophosphamide and should not be delayed for biopsy... In patients with pulmonary-renal syndrome, initial evaluation should include a focused review of systems including constitutional symptoms, rashes, hemoptysis, and hematuria as well as detailed medication reconciliation and substance use history. Early recognition, medication discontinuation, and prompt initiation of glucocorticoids or immunosuppressive therapy are essential. The PEXIVAS trial raises important questions about the optimal treatment approach for AAV with DAH and renal involvement, highlighting the need for further research in this area."

Acute Kidney Injury • ANCA Vasculitis • Anemia • Cardiovascular • Chronic Kidney Disease • Diabetes • Diabetic Nephropathy • Glomerulonephritis • Hematological Disorders • Hypertension • Infectious Disease • Lupus Nephritis • Metabolic Disorders • Nephrology • Obstructive Sleep Apnea • Pneumonia • Pulmonary Disease • Renal Disease • Respiratory Diseases • Rheumatology • Sleep Disorder • Type 2 Diabetes Mellitus • Vasculitis

LEVASIMOLE-ADULTERATED COCAINE VASCULOPATHY: A DUAL THREAT OF PULMONARY HEMORRHAGE AND ACUTE RENAL FAILURE (CHEST 2025) - "He was treated with azathioprine and steroids in the inpatient setting, however he unfortunately was lost to follow up after he left against medical advice. The role of levamisole in the context of its relationship with cocaine and autoimmune vasculitis warrants further study and investigation. Several challenges present when attempting to study levamisole and cocaine given the patient population most commonly affected. The importance of adherence and follow-up must be stressed by providers in order to best aid our patients and to better understand the disease process."

Clinical • Acute Kidney Injury • ANCA Vasculitis • Anemia • Fatigue • Glomerulonephritis • Hematological Disorders • Immunology • Infectious Disease • Lupus Nephritis • Musculoskeletal Pain • Nephrology • Neutropenia • Pulmonary Disease • Renal Disease • Vasculitis

AN UNUSUAL PRESENTATION OF DISSEMINATED MYCOBACTERIUM KANSASII IN THE SETTING OF LEVAMISOLE-INDUCED PANCYTOPENIA (CHEST 2025) - "Liposomal amphotericin B, micafungin, vancomycin, and meropenem were administered...Treatment with ethambutol, rifampin, azithromycin, and amikacin was initiated... While the patient's fulminant shock was likely multifactorial, disseminated Mycobacterium kansasii infection, resulting from an immunocompromised state induced by levamisole-associated pancytopenia, is suspected to have been a significant contributor to his death. Levamisole toxicity should be considered in any patient with a history of cocaine use and cytopenia. Furthermore, in severely immunocompromised patients, mycobacterial infections may not present in typical epidemiological populations."

Acute Kidney Injury • Acute Respiratory Distress Syndrome • CNS Disorders • Hematological Disorders • Infectious Disease • Metabolic Disorders • Neutropenia • Nontuberculous Mycobacterial Disease • Pneumonia • Psychiatry • Pulmonary Disease • Renal Disease • Respiratory Diseases • Schizophrenia • Septic Shock

BREAKING DOWN BARRIERS – DOES A LANGUAGE BARRIER AFFECT OUTCOMES IN CHILDREN AND YOUNG PEOPLE WITH MINIMAL CHANGE NEPHROTIC SYNDROME? (ESPN 2025) - "This study shows no significant difference in outcomes in ES and NES patients suggesting language support mitigated healthcare disparities. Our study population live in some of the most deprived areas which may contribute to these findings. Interestingly, ES patients had a slightly higher relapse rate."

Clinical • Glomerulonephritis • Nephrology • Pediatrics • Renal Disease

CLINICAL CHARACTERISTICS, TREATMENT RESPONSES AND PROGNOSIS IN CHILDREN WITH IDIOPATHIC NEPHROTIC SYNDROME: A SINGLE-CENTER RETROSPECTIVE STUDY (ESPN 2025) - "(p<0.01) Table 1: Clinical and Laboratory Features of SSNS vs. SDSN/SRNS Variable Group 1: SSNS (n=27) Group 2: SRNS/SDNS (n=16) p-value Microscopic Hematuria (%) 37.0% 43.8% 0.910 Average Number of Relapses 1.6 ± 0.8 4.2 ± 1.1 <0.01* Use of Second-Line Therapy (%) 14.8% (mostly levamisole) 100% (MMF, CNI, RTX) <0.001* Follow-up Duration (months) 30 ± 15 39 ± 18 0.315 Cumulative Steroid Dose (mg) 2100 ± 300 3700 ± 500 <0.01* Our findings underscore the clinical heterogeneity of idiopathic nephrotic syndrome in children and reinforce the need for tailored therapeutic strategies... Our findings underscore the clinical heterogeneity of idiopathic nephrotic syndrome in children and reinforce the need for tailored therapeutic strategies. Although most patients respond to steroids, many experience relapses, dependence, or resistance requiring alternative immunosuppressants. Approximately 80% achieve remission by adolescence, but..."

Retrospective data • Chronic Kidney Disease • Focal Segmental Glomerulosclerosis • Glomerulonephritis • Nephrology • Pediatrics • Renal Disease • CD80

LEVAMISOLE IN FREQUENTLY RELAPSING AND STEROID-DEPENDENT NEPHROTIC SYNDROME: A 15-YEAR SINGLE CENTER STUDY (ESPN 2025) - "A significant decrease in prednisolone dose and number of relapses was observed in this study in children with FRNS and SDNS, with no side effects reported. A significant decrease in zBMI values was also observed, contributing to a decrease in these patients' morbidity. These results suggest that levamisole therapy is an effective option to treat children with FRNS and SDNS and seems a good choice as a first steroid-sparing agent before considering more potent immunosuppressors."

Clinical • Glomerulonephritis • Nephrology • Pediatrics • Renal Disease

THE ANTIBODIES THAT LURK IN PLAIN SIGHT: A CASE OF MYELOPEROXIDASE ANTINEUTOPHIL CYTOPLASMIC ANTIBODY-ASSOCIATED ORGANIZING PNEUMONIA (CHEST 2025) - "He was discharged on a prednisone taper.The patient reported that his symptoms returned once his prednisone course was finished, several days prior...Of note, the drug has been shown to induce MPO-ANCA positivity, mostly because of levamisole, a chemical substance with which cocaine is usually contaminated... Given the high rate of OP deemed cryptogenic, more research into the relationship between anti-MPO antibodies and the lung disease is warranted. Assessing for ANCA positivity may help in diagnosis."

Clinical • ANCA Vasculitis • Cardiomyopathy • Cardiovascular • Dyslipidemia • Fatigue • Hepatitis C • Hepatology • Hypertension • Infectious Disease • Pneumonia • Rheumatology • Vasculitis • MPO