title: Multi-organ dysfunction due to bath salts: are we aware of this entity?
abstract: Methylenedioxypyrovalerone (MDPV) is a synthetic, cathinone-derivative, central nervous system stimulant taken to produce a cocaine- or methamphetamine-like high. Physical manifestations include tachycardia, hypertension, arrhythmias, hyperthermia, sweating, rhabdomyolysis, hyperkalaemia, disseminated intravascular coagulation, oliguria and seizures. We report a patient who presented with severe metabolic acidosis, multi-organ dysfunction, rhabdomyolysis, hyperkalaemia and seizures. This case highlights that even though a urine drug screen for routine psychostimulant drugs is negative, clinicians need to be vigilant about the adverse effects of MDPV as a possible cause of multi-organ dysfunction. Substances such as this can only be detected by special tests, such as gas/liquid chromatography mass spectrometry. This is the first reported case of MDPV toxicity successfully treated in Australia to the best of our knowledge.
authors.affiliation: Department of Medicine, Angliss Hospital, Melbourne, Victoria, Australia.
authors.forename: Rohith
authors.initials: R
authors.lastname: Valsalan
authors.affiliation: Department of Critical Care Medicine, Royal Hobart Hospital, Hobart, Tasmania, Australia.
authors.forename: Benoj
authors.initials: B
authors.lastname: Varghese
authors.affiliation: School of Medicine, Deakin University, Geelong, Victoria, Australia.
authors.forename: Diya
authors.initials: D
authors.lastname: Soman
authors.affiliation: Department of Critical Care Medicine, Royal Hobart Hospital, Hobart, Tasmania, Australia.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Buckmaster
authors.affiliation: Department of Nephrology, Royal Hobart Hospital, Hobart, Tasmania, Australia.
authors.forename: Steven
authors.initials: S
authors.lastname: Yew
authors.affiliation: Department of Critical Care Medicine, Royal Hobart Hospital, Hobart, Tasmania, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Cooper
mesh_terms: D000328:Adult; D000470:Alkaloids / Q000819:agonists; D001315:Australia; D052117:Benzodioxoles / Q000506:poisoning*; D000697:Central Nervous System Stimulants / Q000506:poisoning*; D015198:Designer Drugs / Q000506:poisoning*; D005334:Fever / Q000139:chemically induced; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans; D008297:Male; D009102:Multiple Organ Failure / Q000139:chemically induced* / Q000628:therapy*; D011759:Pyrrolidines / Q000506:poisoning*; D017582:Renal Replacement Therapy; D012206:Rhabdomyolysis / Q000139:chemically induced; D000094982:Synthetic Cathinone
chemical_list: D000470:Alkaloids; D052117:Benzodioxoles; D000697:Central Nervous System Stimulants; D015198:Designer Drugs; D011759:Pyrrolidines; C023665:cathinone; D000094982:Synthetic Cathinone
keywords: Australia; methylene dioxypyrovalerone; multi-organ dysfunction; renal replacement therapy; toxicology