Fatal multi-organ failure after suicidal overdose with MDMA, `Ecstasy': case report and review of the literature

1999 ◽  
Vol 18 (2) ◽  
pp. 119-125 ◽  
Author(s):  
A Walubo ◽  
D Seger

A 53-year-old prisoner died of multiorgan failure after a suicidal overdose with 3,4-methylenedeoxymethamphe-tamine (MDMA, `Ecstasy'). Twelve hours after ingestion of MDMA, the patient became severely hyperthermic (107.2°F) with evidence of rhabdomyolysis. He subsequently developed acute respiratory distress syndrome (ARDS), disseminated intravascular coagulopathy (DIC) and acute renal failure. At autopsy, plasma concentration of MDMA was 3.05 mg/L. This case shows that MDMA is still abused in our community and clinicians should know the symptoms of MDMA intoxication. In particular, MDMA should be considered when patients have symptoms or signs of increased sympathetic activity. The pathophysiology and treatment of MDMA-induced hyperthermia are discussed.

2021 ◽  
pp. 68-73
Author(s):  
O. Golubovska ◽  
O. Gudzenko ◽  
A. Zaplotna ◽  
I. Shestakova ◽  
O. Bezrodna ◽  
...  

The clinical case of imported falciparum malaria is described in the article. The diagnosis was confirmed on the 6-th day of the disease when cerebral presentations manifested. The course of the disease was severe and it was characterized by serious complications due to late diagnosis and starting of treatment: malaria coma, malaria alhid, acute respiratory distress syndrome, nozocomial pneumonia, acute renal failure, malaria hepatitis, severe hemolytic anemia. The patient recovered. Presentations of severe anemia progressed after plasmodium disappearance in the blood and persisted after discharge of patient from the hospital.


1997 ◽  
Vol 17 (3) ◽  
pp. 449-460 ◽  
Author(s):  
Thomas S. Neuhauser ◽  
Kristen Lancaster ◽  
Robert Haws ◽  
Dennis Drehner ◽  
Margaret L. Gulley ◽  
...  

2008 ◽  
Vol 80 (4) ◽  
pp. 440-443 ◽  
Author(s):  
Jason John ◽  
Siân Allen ◽  
Matthew Perry ◽  
Hitendra R.H. Patel ◽  
Tim O’Brien

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Ian Holmes ◽  
Nathaniel Berman ◽  
Vinicius Domingues

Phenazopyridine is a commonly used urinary analgesic available throughout the United States. Ingestion of large quantities can lead to methemoglobinemia, hemolytic anemia, jaundice, and acute renal failure. We report a case of a 78-year-old male with previously normal renal function who developed acute renal failure and jaundice without methemoglobinemia or hyperbilirubinemia after taking nearly 8 g of phenazopyridine over the course of 4 days. Initially presenting with oliguria, the urine output began to increase by day 2 of his admission, and the creatinine peaked 11 days after he began taking phenazopyridine, and he was discharged safely soon after. To our knowledge, this is the first such case of renal failure and jaundice without methemoglobinemia or hemolytic anemia in an adult patient with normal renal function.


2021 ◽  
Vol 6 (3) ◽  
pp. 96-101
Author(s):  
I. P. Klishch ◽  

Nowadays, acute renal failure remains one of the most complex problems in modern medicine. Multiple studies have proved that acute renal failure is frequently accompanied by the development of acute lung injury and its most severe form – acute respiratory distress syndrome. According to the literature, lethality in case of acute lung injury or acute respiratory distress syndrome is extremely high and is 30-65%. In case of combination of acute renal failure and acute lung injury or acute respiratory distress syndrome, the most frequently observed in critical patients, lethality reaches 80%. The purpose of the study was to study the possibility of ultrastructural changes of the respiratory tract in the lungs due to experimental modeling of acute renal failure. Materials and methods. The experiments were performed on 30 mature white male rats weighting 180-220 grams. Acute renal failure was induced by intramuscular administration of 50% glycerol water solution in dose of 10 ml per 1 kg of body mass. The sampling of lung tissue for electron microscopy study was carried out under the ketamine anaesthesia in 24 hours after beginning of the experiment. The pieces of lung tissue were fixed in 2.5% solution of gluteraldehyde with further postfixation in 1% solution of osmium tetroxide. After dehydration, the material was poured over epon araldite. The cuts, obtained on ultramicrotome “Tesla BS-490”, were studied using electron microscope “PEM-125K”. Results and discussion. In 24 hours after the beginning of the experiment, the changes in the alveolocytes of types I and II, endotheliocytes, alveolar macrophages are accompanied by the development of intracellular edema with ultrastructural disorder of organelles. Because of endotheliocytes edema and aggregation of forming blood elements, some blood capillaries lumens are closed or drastically narrowed. In some blood capillaries, we observe disorder of the luminal membrane integrity of endothelial cells accompanied by exit of the intracellular content into the micro blood vessel lumen. The expressed disorders of structural organization of the components of pulmonary aero-hematic barrier cause the exit of forming blood elements into the interstitial tissue and alveoli. Conclusion. Тhe detected changes in 24 hours of the experiment have a dystrophic-destructive character and are manifested by the development of edema in alveolocytes of types I and II, alveolar macrophages, endotheliocytes of hemocapillaries. Perspective for further research. Considering the severity of ultrastructural changes that develop in experimental acute renal failure, it would be reasonable to conduct a further study in order to find possible methods of prevention and timely correction


Renal Failure ◽  
1995 ◽  
Vol 17 (5) ◽  
pp. 619-627 ◽  
Author(s):  
Joel Melnick ◽  
M. Jane Latimer ◽  
Edward Lee ◽  
William Henrich

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