SIADH and water intoxication related to ecstasy
Cécile Salathé, Anne-Laure Blanc, Damien Tagan
BMJ Case Reports August 29, 2018 DOI: 10.1136/bcr-2018-224731 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | A 19-year-old woman admitted to hospital after recreational ecstasy (MDMA) use |
| Intervention | Hypertonic saline infusion |
| Measures | Urinalysis |
| Topics | MDMA |
| Citations | 16 |
| Key findings | The authors report that a 19-year-old woman developed severe hyponatraemia after ecstasy use, with evidence of both SIADH and subsequent water intoxication. They argue the case illustrates that these two mechanisms can occur sequentially and that hyponatraemia after MDMA ingestion is a potentially fatal complication requiring clinicians to consider the stage of onset. |
Abstract
Recreational drug use is a significant societal issue and remains a clinical challenge in emergency and critical care departments. We report on a 19-year-old woman admitted to hospital semiconscious and with severe hyponatraemia. Urinalysis was positive for methamphetamine and supported a diagnosis of hyponatraemia related to ecstasy use together with a syndrome of inappropriate antidiuretic hormone secretion (SIADH). The woman was transferred to an intensive care unit, where a hypertonic saline infusion was started. Three hours postadmission she developed polyuria. Follow-up urinalysis at this point was consistent with water intoxication. This case is a reminder that hyponatraemia is a potentially fatal complication after the ingestion of 3,4-methylenedioxymethamphetamine, illustrates the sequential nature of an SIADH and water intoxication and highlights the importance of considering the sequence of onset of hyponatraemia, as the patient may be admitted at any stage.
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
Cited by 3
Cites 7
- Hyponatraemic states following 3,4-methylenedioxymethamphetamine (MDMA, 'ecstasy') ingestion The Quarterly journal of medicine July 1, 2002
- Sex Differences in the Effects of MDMA (Ecstasy) on Plasma Copeptin in Healthy Subjects The Journal of Clinical Endocrinology & Metabolism June 30, 2011
- Cerebral oedema after ingestion of MDMA (“ecstasy”) and unrestricted intake of water BMJ May 25, 1996
- 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 2 more in the library