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He was found to have a serum creatinine of 2.5\u2009mg\/dL, microscopic haematuria and subnephrotic proteinuria, along with positive proteinase 3, myeloperoxidase, anticardiolipin antibodies and an elevated antinuclear antibody titre. The renal pathology revealed focal necrotising glomerulonephritis with crescentic features and mild immune type deposition. The patient was treated with cocaine abstinence, pulse dose steroids followed by maintenance prednisone, rituximab and cyclophosphamide. His renal function subsequently improved but did not normalise. We believe that his incomplete improvement was due to the degree of kidney injury on presentation as well as recidivism with cocaine use.<\/jats:p>","DOI":"10.1136\/bcr-2018-225913","type":"journal-article","created":{"date-parts":[[2018,9,19]],"date-time":"2018-09-19T18:03:25Z","timestamp":1537380205000},"page":"bcr-2018-225913","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Unusual case of levamisole-induced dual-positive ANCA vasculitis and crescentic 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