It is thought to intensify the "high" by releasing dopamine in the brain, acts as a bulking agent, and is a difficult adulterant to recognize.
Potential risks of levamisole-laced cocaine include neutropenia, agranulocytosis, arthralgias, retiform purpura, skin necrosis, and fever.
[5][6] LINES was first described in a 54-year-old male with history of hypothyroidism who presented to an urgent care facility with bilateral axillary adenopathy and severe malaise.
Incision and drainage of the nodes was performed and he was discharged home with sulfamethoxazole/trimethoprim for presumed methicillin-resistant Staphylococcus aureus (MRSA) infection.
Erythrocyte sedimentation rate was elevated at 35 mm/hour; cardiolipin IgM was weakly positive at 16.3; C4 was decreased at 10 mg/dl; antinuclear antibodies were negative and p-ANCA was reactive.
[7] In 2011 a team of physicians from University of South Florida Morsani College of Medicine in Tampa, FL (under the attending service of John T. Sinnott, MD FACP) recognized an association of skin necrosis with use of levamisole adulterated cocaine.