Background: The illegal consumption of cocaine adulterated with levamisole is increasing worldwide. Vasculitis and agranulocytosis generated by this component have been widely studied, however, both micro and macrovascular thrombotic vasculopathy continues to be an area of study due to its impact on the prognosis and additional management measures.

Aims: To determine the frequency of patients with thrombotic vasculopathy as a manifestation and to describe the clinical and main laboratory findings.

Methods: A descriptive, retrospective study was performed. Patients with levamisole-induced vasculopathy (LIVEN) evaluated from December 2010 to December 2021 were included. Descriptive statistics were calculated through Jamovi, ver 1.6.7.0.

Results: A total of 60 patients with a diagnosis of LIVEN were included in the follow-up cohort: 16 presented thrombotic vasculopathy as a manifestation (26.6%). The mean age was 34 years, 81.2% of the patients were men. Thrombotic microangiopathy was documented in 13 patients by skin biopsy (21.6%) and only 3 presented macrovascular venous thromboembolic events (5%). The events of macrovascular thrombosis were deep vein thrombosis, 1 in the upper limb and 2 in the lower limbs. 75% of patients with thrombotic vascular disease had at least one antiphospholipid antibody present. None of the patients included in the follow-up presented arterial thrombosis as a manifestation. (Table1-2)

Conclusion(s): Thrombotic manifestations are infrequent in patients with LIVEN, microvascular involvement by biopsy being more frequent than macrovascular venous thromboembolic events

Table 1

Clinical and Laboratory Characteristics of Patients with LIVEN-Associated Thrombotic Vasculopathy

Table 2

Characteristics of the antibody antiphospholipid profile

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ISTH Congress Abstracts - https://abstracts.isth.org/abstract/thrombotic-events-as-a-manifestation-of-vasculitis-vasculopathy-induced-by-cocaine-adulterated-with-levamisole-in-a-colombian-cohort/