The Journal of emergency medicine · 2009
Ecstasy-associated acute severe hyponatremia and cerebral edema: a role for osmotic diuresis?
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Ghatol Abhijeet, Kazory Amir
Аннотация
BACKGROUND: Ecstasy, or 3,4-methylenedioxymethamphetamine (MDMA), is a drug of abuse with a wide range of toxicity affecting the brain, heart, and liver. Renal toxicity of MDMA is due either to acute kidney injury (e.g., non-traumatic rhabdomyolysis) or to water and electrolyte imbalance (i.e., hyponatremia). Although syndrome of inappropriate secretion of antidiuretic hormone has been recognized as a major mechanism for MDMA-associated hyponatremia, other factors (e.g., MDMA-induced polydipsia) have also been proposed.
OBJECTIVES: Hypertonic saline has been used by most authors to treat MDMA-associated acute symptomatic hyponatremia. Our case is the second published report in which mannitol was chosen for management of this pathologic phenomenon.
CASE REPORT: We present a case of MDMA-associated acute severe hyponatremia and cerebral edema in a young female, and analyze the underlying pathophysiology, the therapeutic strategy, and the course of disease.
CONCLUSION: Based on this observation, coupled with the previous report and the complex pathophysiology of this phenomenon, we suggest that osmotic diuresis be considered a possible therapeutic option for MDMA-associated acute symptomatic hyponatremia.
OBJECTIVES: Hypertonic saline has been used by most authors to treat MDMA-associated acute symptomatic hyponatremia. Our case is the second published report in which mannitol was chosen for management of this pathologic phenomenon.
CASE REPORT: We present a case of MDMA-associated acute severe hyponatremia and cerebral edema in a young female, and analyze the underlying pathophysiology, the therapeutic strategy, and the course of disease.
CONCLUSION: Based on this observation, coupled with the previous report and the complex pathophysiology of this phenomenon, we suggest that osmotic diuresis be considered a possible therapeutic option for MDMA-associated acute symptomatic hyponatremia.