Agranulocytosis After Consumption of Cocaine Adulterated With Levamisole

  1. Nancy Y. Zhu, MD;
  2. Donald F. LeGatt, PhD; and
  3. A. Robert Turner, MD
  1. From the University of Alberta, Edmonton, Alberta T6G 2B7, Canada.
    1. Figure.
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        Figure. Photographs of bone marrow aspirate (top) and trephine biopsy (bottom) from a patient with agranulocytosis and levamisole found in the urine.

        Neutrophils and bands are almost completely absent. The abundance of granulocytic precursors suggests toxin-related impairment of granulopoiesis with reduction of neutrophil maturation. The remainder of the bone marrow shows normal heterogeneity. Top. Bone marrow aspirate (May-Grünwald–Giemsa stain). Bottom. Bone marrow trephine biopsy (hematoxylin–eosin stain).

      Responses to this article

      • Re: Observations regarding levamisole in the cocaine supply
        • Eric J Lavonas and
        • Jennie A. Buchanan
        Ann Intern Med published online October 26, 2009
      • Observations regarding levamisole in the cocaine supply
        • Laureen J. Marinetti
        Ann Intern Med published online October 26, 2009
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      1. Ann Intern Med February 17, 2009 vol. 150 no. 4 287-289
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