Supplementary Material for: ANCA Associated Vasculitis Secondary to Levamisole-Adultered Cocaine with Associated Membranous Nephropathy: A Case Series

Background: Cocaine is a risk factor for acute kidney
injury and chronic kidney disease with progression to end-stage renal
disease. Levamisole is an adulterant that is added to cocaine to enhance
its euphoric effects. Levamisole-adulterated cocaine (LAC) is
associated with the distinct clinical syndromes of agranulocytosis,
leukocytoclastic vasculitis, cocaine-induced midline destructive lesions
(CIMDL), and ANCA-associated vasculitis (AAV) with pauci-immune
necrotizing glomerulonephritis. Methods: We reviewed all cases of AAV secondary to LAC at our institution. Results:
We report 3 cases of AAV secondary to LAC and associated membranous
nephropathy (MN). The first and second cases are concurrent AAV
secondary to LAC and associated MN while the third case involves the
development of MN after AAV secondary to LAC. Conclusions: Clinicians should be aware of this novel association of LAC with MN.