Late diagnosis of MDMA-related severe hyponatremia
Julia Chia‐yu Chang, Jiin Ger, Chen-Chang Yang
Case Reports in Internal Medicine May 27, 2014 DOI: 10.5430/crim.v1n2p153 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | 24-year-old female patient with altered mental status |
| Topics | MDMA |
| Keywords | Hyponatremia Coma optics Altered mental status Amphetamine Anesthesia Pediatrics |
| Citations | 21 |
| Key findings | MDMA-induced hyponatremic coma can be easily overlooked without exposure history or typical sympathomimetic effects, making prompt toxicological screening crucial. |
Abstract
Introduction : 3, 4-methylenedioxymethamphetamine (MDMA) is a popular psychoactive amphetamine derivative with the potential to induce life-threatening hyponatremia. The absence of exposure history and typical toxidromes however make the prompt diagnosis of MDMA-induced hyponatremic coma difficult and easily overlooked. Case Report : A 24-year-old female presented to the emergency department with an altered mental status. Physical examinations, laboratory workup and brain imaging study were remarkable for severe hyponatremia (serum sodium 116 mmol/L) and diffuse brain edema only. Her family denied that she had used any illicit drugs. The diagnosis of MDMA-related hyponatremic coma was not made until six days later when toxicologic screen confirmed the presence of high concentration of MDMA (7,767 ng/ml) in the patient’s urine. Conclusion : Our case demonstrates the difficulty in the correct diagnosis of MDMA-induced hyponatremic coma in the absence of MDMA exposure history and typical sympathom imetic effects. A high index of suspicion and prompt toxicological screen are thus important in the diagnosis of MDMA-related severe hypontremia.
Comparable studies
Other case reports and case series on MDMA, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| 'Eve' and 'Ecstasy'. A report of five deaths associated with the use of MDEA and MDMA Individuals whose deaths were associated with MDMA or MDEA use | 1987 | Case series | n = 5 |
| Pathology of deaths associated with "ecstasy" and "eve" misuse. Young white men aged 20 to 25 who died after using ring-substituted amphetamines (MDMA... | 1996 | Case series | n = 7 |
| 'Eve' and 'Ecstasy' Individuals who died after using MDMA or MDEA | 1987 | Case series | n = 5 |
| A Method of Conducting Therapeutic Sessions with MDMA Clients with clear therapeutic purpose, excluding those with serious functional... | 1998 | Case study | n = 2 |
| Diversity of Psychopathology Associated with use of 3,4-Methylenedioxymethamphetamine (‘Ecstasy’) Psychiatric patients presenting between 1990 and 1992 whose symptoms developed in the... | 1994 | Case series | n = 13 |
Citations in the library
Cites 9
- Mood and cognitive effects of ± 3,4‐methylenedioxymethamphetamine (MDMA, ‘ecstasy’): week‐end ‘high’ followed by mid‐week low Addiction July 1, 1997
- Multiple Severe Complications From Recreational Ingestion of MDMA ('Ecstasy') JAMA August 14, 1987
- Sex Differences in the Effects of MDMA (Ecstasy) on Plasma Copeptin in Healthy Subjects The Journal of Clinical Endocrinology & Metabolism June 30, 2011
- Action of MDMA (Ecstasy) and Its Metabolites on Arginine Vasopressin Release Annals of the New York Academy of Sciences June 1, 2002
- High incidence of mild hyponatraemia in females using ecstasy at a rave party. Nephrology, Dialysis, Transplantation September 2013
and 4 more in the library