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[Ecstasy-induced toxic hepatitis].

Xavier Aknine

Presse medicale (Paris, France : 1983) October 23, 2004 DOI: 10.1016/s0755-4982(04)72377-5 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Case report Peer reviewed
Sample size 1
Population A 21-year-old man who used ecstasy (MDMA) and cannabis
Intervention Ecstasy (MDMA)
Duration One month after discontinuation of the drug
Topics MDMA
Key findings The authors report that a 21-year-old man's abnormal liver profile and persistent anaemia were highly probably caused by ecstasy (MDMA), since transaminases normalized one month after he stopped the drug, hepatitis viral markers were negative, and no other psychoactive drugs besides cannabis were reported. They note that MDMA hepatotoxicity ranges from acute to lethal fulminant hepatitis, is poorly understood mechanistically, and does not appear dose-dependent or related to cumulative exposure.

Abstract

The use of ecstasy (MDMA) has developed in the young since the eighties, particularly in festive settings. Among the severe adverse events induced by this synthetic drug, the hepatotoxicity related to MDMA and to its physiopathological mechanism warrant attention. A 21 year-old man consulted for anaemia that had persisted over the past months with abnormality in hepatic profile. The imputability of ecstasy in perturbations in his hepatic profile was highly probable in view of the fact that his transaminase level returned to normal one month after he stopped taking the drug, all the viral markers of hepatitis became negative and in the absence of concomitant consumption of any psycho-active drugs other than cannabis. A review of the literature showed the great variability in clinical pictures related to the hepato-toxicity of ecstasy, ranging from acute to lethal, fulminating hepatitis. The physiopathological mechanism of this phenomenon is little known. Various hypotheses are evoked with, among others, immuno-allergic-type hypersensitivity, phenomenon of apoptosis, vitamin E deficiency, and the role of occasionally concomitant malignant hyperthermia. The part played by the metabolites of the synthetic drug has also been suggested as well as individual variations in genetic origin with regards to the risk of developing acute hepatitis after ingestion of ecstasy. The hepato-toxicity of this drug does not appear to be dose-dependant nor related to the cumulated duration of exposure.

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

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