Cutaneous vasculitis secondary to levamisole treatment in the nephrotic syndrome in paediatrics

Introduction: Nephrotic syndrome (NS) is a common childhood glomerular disease. The most common presentation in paediatric population is the idiopathic syndrome (INS). Treatment with levamisole is effective in frequent relapsing and corticosteroid-dependent NS. Studies have reported mild and rarely severe side effects, which subside after treatment withdrawal. Results: We describe two clinical cases of frequently relapsing INS treated with levamisole that presented with cutaneous vasculitis with positive anti-neutrophil cytoplasmic antibodies. Both cases had skin lesions that disappeared after withdrawal of the drug, avoiding the use of other treatments with corticosteroids, immunomodulators and even amputations due to skin necrosis. Conclusions: It is important to know the possible complications of levamisole treatment in paediatric patients with INS to proceed with drug withdrawal for resolution.