title: Rapidly reversible multiorgan failure after ingestion of "Molly" (pure 3,4-methylenedioxymethamphetamine): a case report.
abstract: BACKGROUND
  "Molly" is a street name for pure 3,4-methylenedioxymethamphetamine, an amphetamine derivative which acts by enhancing the release of neurotransmitters such as serotonin, dopamine and norepinephrine. This produces euphoria, increased sensory awareness and central stimulation that make it a popular club drug. Nevertheless, it is also associated with serious side effects. We report an unusual case of rapid multiorgan failure after ingestion of "Molly". Unlike previously described patterns of 3,4-methylenedioxymethamphetamine-related organ failure, our case does not appear to be related to hyperthermia, rhabdomyolysis or hyponatremia.
  
  
  METHODS
  A 24-year-old Hispanic man presented to our hospital with an episode of seizure and subsequently developed acute kidney injury, respiratory failure requiring mechanical ventilation and congestive heart failure after ingestion of "Molly". He rapidly recovered with supportive care and was discharged home.
  
  
  CONCLUSIONS
  The spectrum of complications associated with 3,4-methylenedioxymethamphetamine is wide and patient presentation may vary. Moreover, there appears to be multiple mechanisms involved in organ failure. Drug toxicity should be suspected while evaluating a patient with multisystem organ failure of unclear etiology. Treatment is generally supportive sometimes requiring mechanical ventilation and hemodialysis. Nevertheless, complete reversal of organ failure can be expected.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Bronx Lebanon Hospital Center, Bronx, NY, USA. truptivakde@gmail.com.
authors.forename: Trupti
authors.initials: T
authors.lastname: Vakde
authors.forename: Manuel
authors.initials: M
authors.lastname: Diaz
authors.forename: Kalpana
authors.initials: K
authors.lastname: Uday
authors.forename: Richard
authors.initials: R
authors.lastname: Duncalf
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced / Q000628:therapy; D000328:Adult; D006333:Heart Failure / Q000139:chemically induced; D006801:Humans; D013287:Illicit Drugs / Q000009:adverse effects*; D008297:Male; D009102:Multiple Organ Failure / Q000139:chemically induced* / Q000628:therapy; D018817:N-Methyl-3,4-methylenedioxyamphetamine / Q000009:adverse effects*; D006435:Renal Dialysis
chemical_list: D013287:Illicit Drugs; D018817:N-Methyl-3,4-methylenedioxyamphetamine