Late diagnosis of MDMA-related severe hyponatremia
Case Reports in Internal Medicine May 27, 2014 Julia Chia‐yu Chang, Jiin Ger, Chen-Chang Yang 21 citations
A 24-year-old woman arrived at the emergency department with altered mental status. Tests showed severe hyponatremia (serum sodium 116 mmol/L) and diffuse brain edema, but no history of drug use was reported. The correct diagnosis of MDMA-induced hyponatremic coma was delayed until six days later, when a toxicology screen revealed a high urine concentration of MDMA (7,767 ng/ml). This case illustrates how the absence of exposure history and typical stimulant effects can make MDMA-related hyponatremic coma easy to overlook. A high index of suspicion and prompt toxicological screening are essential for diagnosing such cases.