Chronic ecstasy (3,4-methylenedioxymetamphetamine) abuse: a recurrent and unpredictable cause of severe acute hepatitis.
H Fidler, A Dhillon, D Gertner, A Burroughs
Journal of Hepatology October 1996 DOI: 10.1016/s0168-8278(96)80217-0 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case report Peer reviewed |
|---|---|
| Sample size | 2 |
| Population | Young people with ecstasy-associated acute hepatitis |
| Interventions | Ecstasy (MDMA 3 4-methylenedioxymetamphetamine) |
| Topics | MDMA |
| Key findings | Two patients with recurrent ecstasy-associated hepatitis had variable intervals between drug consumption and jaundice, obscuring the link; liver biopsies showed acute hepatitis (one mild, one severe with features suggesting auto-immune hepatitis), and both resolved spontaneously. The authors argue that clinicians need a high index of suspicion and specific questioning to diagnose the condition and counsel abstinence, because subsequent attacks may be fatal and insidious chronic damage may occur. |
Abstract
Fifteen reports of hepatitis induced by ecstasy (MDMA, 3,4-methylenedioxymetamphetamine) have been published over the last 3 years. With the increasing enthusiasm for "Rave" parties, the incidence appears to be increasing, and is an important and often concealed cause of acute hepatitis in young people. We report two cases of recurrent ecstasy-associated hepatitis where the interval between drug consumption and jaundice was variable and the link therefore initially obscured. Liver biopsies of both patients showed acute hepatitis. One was of relatively mild degree, and the other was severe, with features suggesting auto-immune hepatitis. Both cases resolved spontaneously. A high index of suspicion and careful specific enquiry are necessary to make the diagnosis and warn the patient to abstain in future, since subsequent attacks may be fatal and insidious chronic damage may occur.
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 6
- Review article: mechanisms and management of hepatotoxicity in ecstasy (MDMA) and amphetamine intoxications Alimentary Pharmacology & Therapeutics February 1, 1999
- Deaths from exposure to paramethoxymethamphetamine in Alberta and British Columbia, Canada: a case series. CMAJ Open January 13, 2015
- Biochemical, pharmacological, and toxic effects of n-metil 3,4-methylenedioxyamphetamine - "ecstasy" Vojnosanitetski Pregled 2005
- Acute toxic effects of 'Ecstasy' (MDMA) and related compounds: overview of pathophysiology and clinical management. British Journal of Anaesthesia June 2006
- The health effects of ecstasy: a literature review. Drug and Alcohol Review March 2002
and 1 more in the library