title: Full recovery after severe serotonin syndrome, severe rhabdomyolysis, multi-organ failure and disseminated intravascular coagulopathy from MDMA.
abstract: 3, 4-methylenedioxymethamphetamine (MDMA), popularly known as "ecstasy" is a synthetic, psychoactive drug used recreationally for its euphoric and "energy increasing" effects. MDMA has been linked to several severe adverse effects including the development of serotonin syndrome and sudden death. Individuals of Asian descent have been shown to have a predisposition for these severe adverse effects. We present a case of a young Asian-American male who following MDMA ingestion presented with severe rhabdomyolysis (CK 130,350 U/L), multiple organ failure and severe serotonin syndrome with one of the highest recorded temperatures '108.9 °F (42.7 °C)' in a survivor of severe serotonin syndrome. The patient initially received supportive care including ventilatory support; he eventually needed hemodialysis, but went on to make a full recovery within 3 weeks. This case shows and emphasizes the importance of 'aggressive' supportive care on patient prognosis particularly for patients on the extreme end of the serotonin syndrome.
authors.affiliation: Internal Medicine Department, Columbia University at Harlem Hospital Center, 506 Lenox Avenue, MLK 14-106, New York, NY 10037, USA. Electronic address: od2178@columbia.edu.
authors.forename: O
authors.initials: O
authors.lastname: Davies
authors.affiliation: Internal Medicine Department, Columbia University at Harlem Hospital Center, 506 Lenox Avenue, MLK 14-106, New York, NY 10037, USA.
authors.forename: B
authors.initials: B
authors.lastname: Batajoo-Shrestha
authors.affiliation: Internal Medicine Department, Columbia University at Harlem Hospital Center, 506 Lenox Avenue, MLK 14-106, New York, NY 10037, USA.
authors.forename: J
authors.initials: J
authors.lastname: Sosa-Popoteur
authors.affiliation: Pulmonary and Critical Care Medicine Department, Columbia University at Harlem Hospital Center, 506 Lenox Avenue, MLK 14-108, New York, NY 10037, USA.
authors.forename: M
authors.initials: M
authors.lastname: Olibrice
mesh_terms: D004211:Disseminated Intravascular Coagulation / Q000139:chemically induced*; D006213:Hallucinogens / Q000009:adverse effects*; D006801:Humans; D008297:Male; D009102:Multiple Organ Failure / Q000139:chemically induced*; D018817:N-Methyl-3,4-methylenedioxyamphetamine / Q000009:adverse effects*; D006435:Renal Dialysis; D012206:Rhabdomyolysis / Q000139:chemically induced*; D020230:Serotonin Syndrome / Q000139:chemically induced* / Q000628:therapy; D055815:Young Adult
chemical_list: D006213:Hallucinogens; D018817:N-Methyl-3,4-methylenedioxyamphetamine
keywords: Ecstasy; Hyperthermia; MDMA; Serotonin; Toxicity