Pathology of deaths associated with "ecstasy" and "eve" misuse.
Journal of Clinical Pathology February 1, 1996 Christopher M. Milroy, Jenny Clark, A.r.w. Forrest 275 citations
In seven young white men aged 20 to 25 who died after using ring-substituted amphetamines (MDMA or MDEA), autopsies revealed liver damage ranging from individual cell death to widespread centrilobular necrosis, with one case of massive hepatic necrosis. Heart changes consistent with catecholamine-induced damage appeared in five cases, and brain perivascular hemorrhagic or hypoxic changes in four. Four cases showed changes similar to those seen in heat stroke, though only two had documented hyperthermia. One man died from fulminant liver failure, one from water intoxication, and one likely from a cardiac arrhythmia linked to myocardial fibrosis. The findings suggest multiple injury mechanisms: hyperthermia in some cases and direct toxic effects on liver and other organs even without hyperthermia.