ANCA-Associated Intrahepatic Duct Injury Associated with Levamisole-Adulterated Cocaine

Division

North Florida

Hospital

North Florida Regional Medical Center

Document Type

Case Report

Publication Date

12-23-2020

Keywords

hepatic duct cholestasis, intrahepatic duct damage, substance-related disorders

Disciplines

Digestive System Diseases | Gastroenterology | Hepatology

Abstract

Damage to the liver or kidney can occur through direct toxic effects; however, damage can also be drug-induced immune-mediated. Levamisole-adulterated cocaine (LAC) is known to cause antineutrophil cytoplasmic antibody- (ANCA-) associated vasculitis and glomerulonephritis leading to acute kidney injury and end-stage renal disease. It remains unclear whether LAC is associated with hepatic duct damage. Here, we report a case with biopsy-proven evidence of intrahepatic duct damage months after being diagnosed with ANCA-associated crescentic and sclerosing glomerulonephritis caused by LAC use. This case represents the first report of LAC-induced ANCA-associated hepatic duct cholestasis in the setting of previous LAC-induced ANCA-positive glomerulonephritis.

Publisher or Conference

Case Reports in Hepatology

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