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Cocaine Use Likely Cause of Agranulocytosis Clusters

Studies done in four states find levamisole, a cocaine additive, to be source of agranulocytosis

MONDAY, Dec. 21 (HealthDay News) -- Four separate clusters of agranulocytosis may potentially be linked to the ingestion of a veterinary drug, levamisole, which is commonly used as an added ingredient during cocaine manufacturing, according to a study published in the Dec. 18 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

Monica Brackney, of the New Mexico Department of Health in Santa Fe, and colleagues report that a cluster of 11 otherwise unexplained cases of agranulocytosis were picked up by a reference laboratory in New Mexico in April 2008 and subsequent investigation revealed all cases were linked to exposure to cocaine.

In addition, the authors note that an investigation in Seattle, from April to November 2009, detected 10 cases of agranulocytosis, which were associated with cocaine use. Of the 21 cases identified in the states of New Mexico and Washington, levamisole was the common link to development of agranulocytosis, as was also demonstrated by investigations completed in Alberta and British Columbia, Canada.

"According to the Drug Enforcement Administration, as of July 2009, 69 percent of seized cocaine lots coming into the United States contained levamisole as an added agent," the authors write. "Levamisole in cocaine was the likely cause of the agranulocytosis. Health care providers should consider these findings in the differential diagnosis of agranulocytosis, and public health officials should be aware of cases of agranulocytosis associated with cocaine use."

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