What are the most common drugs that cause leukocytoclastic vasculitis (LCV)?

Updated: Dec 09, 2020
  • Author: A Brooke W Eastham, MD; Chief Editor: Herbert S Diamond, MD  more...
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Answer

The most common drugs that cause LCV are antibiotics, particularly beta-lactam drugs, nonsteroidal anti-inflammatory drugs, and diuretics. However, almost all drugs are potential causes. Foreign proteins such as streptokinase, those found in vaccines, [19] and those used in monoclonal antibody therapy can be associated with a serum sickness syndrome with LCV.

LCV has been reported in users of cocaine adulterated with levamisole, a veterinary anthelminthic drug that was withdrawn from human use because of adverse effects including vasculitis but is found in as much as 70% of cocaine in the United States. [20]  Although most cases of levamisole-induced LCV are associated with high titers of antineutrophil cytoplasmic antibodies (ANCA), ANCA-negative vasculitis also occurs in levamisole-adulterated cocaine. [21]  


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