title: Liver transplantation for the treatment of fulminant hepatic failure induced by the ingestion of ecstasy.
abstract: Methylenedimethoxymethamphetamine (MDMA), more commonly known as ecstasy, is a synthetic amphetamine derivative used by teenagers and young adults in the United States as well as in Western Europe as a "dance drug". Though a number of complications associated with this drug have been reported, there is little information pertaining to hepatoxity as a result of MDMA ingestion. This case report is about an 18-year-old female patient who regularly used ecstasy on weekends over a 2-month period. Within 2 days after accepting a "hit" of the substance at a party, she was admitted to the hospital because of lethargy, vomiting, abdominal pain, stool discoloration, icterus, and darkened urine. On day 7 she developed fulminant hepatic failure with reduced hepatic coagulation factors and grade IV encephalopathy. Orthotopic liver transplantation was carried out 10 days following the ingestion. The patient made a full recovery within 72 h and was released from the hospital 6 weeks later. Histopathological examination of the removed liver revealed a nutritive-toxic liver necrosis. This case demonstrates that the ingestion of ecstasy, even on an infrequent basis, can lead to acute fulminant liver necrosis, and that this life-threatening complication can be treated successfully by liver transplantation.
authors.affiliation: Department of Surgery, Klinikum rechts der Isar, Technical University Munich, Germany.
authors.forename: R B
authors.initials: RB
authors.lastname: Brauer
authors.forename: C D
authors.initials: CD
authors.lastname: Heidecke
authors.forename: W
authors.initials: W
authors.lastname: Nathrath
authors.forename: K T
authors.initials: KT
authors.lastname: Beckurts
authors.forename: P
authors.initials: P
authors.lastname: Vorwald
authors.forename: T R
authors.initials: TR
authors.lastname: Zilker
authors.forename: U
authors.initials: U
authors.lastname: Schweigart
authors.forename: A H
authors.initials: AH
authors.lastname: Hölscher
authors.forename: J R
authors.initials: JR
authors.lastname: Siewert
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D017114:Liver Failure, Acute / Q000139:chemically induced / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D018817:N-Methyl-3,4-methylenedioxyamphetamine / Q000009:adverse effects*
chemical_list: D018817:N-Methyl-3,4-methylenedioxyamphetamine