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Study Identifies Risk Factors for Cocaine/Levamisole-Associated Autoimmunity Syndrome
Gender and race are key variables in determining the likelihood of developing cocaine/levamisole-associated autoimmunity syndrome (CLAAS), according to new research. Along with demographic factors, the study authors evaluated the clinical and immunologic correlates of the drug-induced autoimmunity.
For the study, 50 individuals with CLAAS seen at the University of Washington Medical Center, Harborview Medical Center, and affiliated clinics in Seattle, Washington, between 2001 and 2015 were evaluated for their demographic, clinical, and immunologic variables.
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Participant data were compared with data from an associated deidentified clinical data repository of 2740 individuals who were positive for antineutrophil cytoplasmic antibodies (ANCAs) or who used cocaine.
The participants with CLAAS were more likely to be women and less likely to identify themselves as black/African American compared with the participants from the data repository who used cocaine. The study authors noted that gender and race are important risk modifiers in developing CLAAS among individuals who use cocaine.
Those in the CLAAS group also showed patterns of ANCAs, including anti-myeloperoxidase/anti-proteinase 3 dual reactivity, which the authors determined may be specific to CLAAS.
Cytoplasmic ANCA development also was connected to an increase in mortality.
“The enriched presence of anti-MPO/anti-PR3 dual reactivity in CLAAS further supports the diagnostic utility of this feature,” the authors wrote.
Hematologic, renal, and skin abnormalities, such as neutropenia and skin purpura, were the most commonly reported complications among participants.
—Colleen Murphy
Reference:
Morcos MB, Lood C, Hughes GC. Demographic, clinical, and immunologic correlates among a cohort of 50 cocaine users demonstrating antineutrophil cytoplasmic antibodies [published online May 15, 2019]. J Rheumatol. https://www.jrheum.org/content/early/2019/05/13/jrheum.180771.
