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Acute hyponatraemia and ‘ecstasy’: insights from a quantitative and integrative analysis
A 20‐year‐old woman attended a ‘rave party’ where she took the drug 3,4‐methylenedioxymethamphetamine (MDMA, ‘ecstasy’). She had used this drug previously without serious adverse effects. On this occasion, while both she and her friends drank a large quantity of water, only she became seriously ill....
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Published in: | QJM : An International Journal of Medicine 2002-07, Vol.95 (7), p.475-483 |
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Main Authors: | , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that cite this one |
Online Access: | Get full text |
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Summary: | A 20‐year‐old woman attended a ‘rave party’ where she took the drug 3,4‐methylenedioxymethamphetamine (MDMA, ‘ecstasy’). She had used this drug previously without serious adverse effects. On this occasion, while both she and her friends drank a large quantity of water, only she became seriously ill. The initial manifestation was an altered sensorium; several hours later she had a grand mal seizure. In the Emergency Department, the most striking features were the severe degree of hyponatraemia (112 mmol/l) and cerebral oedema. To explain the basis for this life‐threatening clinical presentation, an imaginary consultation was sought with Professor McCance. Using both a deductive and a quantitative analysis that involved several medical subspecialties, he illustrated that a simple story of water ingestion and vasopressin release was not sufficient to explain her hyponatraemia. It was only after events in her gastrointestinal tract were analysed that a plausible hypothesis could be constructed. |
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ISSN: | 1460-2725 1460-2393 1460-2393 |
DOI: | 10.1093/qjmed/95.7.475 |