Ausgeprägte Hyperthermie und Rhabdomyolyse nach Ecstasy (MDMA)-Intoxikation

Kunitz, Oliver; İnce, Ali Rıza; Kuhlen, Ralf; Rossaint, Rolf

doi:10.1007/s00101-003-0474-2

Cited by 16 publications

(7 citation statements)

References 9 publications

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“…It has been reported that body temperature may reach up to 43°C, which can be fatal [221][222][223][224]. Misuse of MDMA in crowded conditions with a high ambient temperature, physical activity, and dehydration, i.e., under conditions that MDMA is often used at "dance parties", may all contribute to increase the hyperthermic response.…”

Section: Mdma-induced Acute Human Peripheral Symptoms a Special Focumentioning

confidence: 99%

“…More severe acute effects include acute panic disorder and psychosis, arrhythmias and cardiovascular collapse with histological postmortem changes ranging from contraction band necrosis to individual myocyte necrosis, severe hyperpyrexia, liver failure accompanied by foci of individual cell necrosis to centrilobular necrosis and microvascular steatosis, acute renal failure with histological tubular necrosis, rhabdomyolysis and multi-organ failure, disseminated intravascular coagulation, hyponatremia with cerebral edema, the 5-HT syndrome, and sudden death [174,211,222,224,232,233]. In addition, potentially fatal neurological effects can occur following MDMA ingestion, including subarachnoid hemorrhage, intracranial hemorrhage or cerebral infarction, and cerebral venous sinus thrombosis [174,211,231].…”

Section: Mdma-human Acute Toxicitymentioning

confidence: 99%

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Molecular and Cellular Mechanisms of Ecstasy-Induced Neurotoxicity: An Overview

et al. 2009

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"Ecstasy" [(+/-)-3,4-methylenedioxymethamphetamine, MDMA, XTC, X, E] is a psychoactive recreational hallucinogenic substance and a major worldwide drug of abuse. Several reports raised the concern that MDMA has the ability to induce neurotoxic effects both in laboratory animals and humans. Despite more than two decades of research, the mechanisms by which MDMA is neurotoxic are still to be fully elucidated. MDMA induces serotonergic terminal loss in rats and also in some mice strains, but also a broader neuronal degeneration throughout several brain areas such as the cortex, hippocampus, and striatum. Meanwhile, in human "ecstasy" abusers, there are evidences for deficits in seronergic biochemical markers, which correlate with long-term impairments in memory and learning. There are several factors that contribute to MDMA-induced neurotoxicity, namely, hyperthermia, monoamine oxidase metabolism of dopamine and serotonin, dopamine oxidation, the serotonin transporter action, nitric oxide, and the formation of peroxinitrite, glutamate excitotoxicity, serotonin 2A receptor agonism, and, importantly, the formation of MDMA neurotoxic metabolites. The present review covered the following topics: history and epidemiology, pharmacological mechanisms, metabolic pathways and the influence of isoenzyme genetic polymorphisms, as well as the acute effects of MDMA in laboratory animals and humans, with a special focus on MDMA-induced neurotoxic effects at the cellular and molecular level. The main aim of this review was to contribute to the understanding of the cellular and molecular mechanisms involved in MDMA neurotoxicity, which can help in the development of therapeutic approaches to prevent or treat the long-term neuropsychiatric complications of MDMA abuse in humans.

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Section: Mdma-induced Acute Human Peripheral Symptoms a Special Focumentioning

confidence: 99%

Section: Mdma-human Acute Toxicitymentioning

confidence: 99%

Molecular and Cellular Mechanisms of Ecstasy-Induced Neurotoxicity: An Overview

et al. 2009

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“…Thus, the myoglobin staining results might underpin the hypothesis, causing relevant muscle damage due to shivering caused by raised body temperature, and seemed to be associated with prolonged agony phases of death, which is explainable by regular and repeated consumption rather than heavy single doses of METH [ 28 ]. Of course, muscle protein staining in kidneys of drug abusers is not associated with METH alone, as there are post-mortem and clinical case reports on MOR and ‘ecstasy’ intoxications as well [ 29 – 31 ]. Nonetheless, METH abuse is becoming an increasingly common cause of rhabdomyolsis in clinical settings [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

Drug- and/or trauma-induced hyperthermia? Characterization of HSP70 and myoglobin expression

et al. 2018

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IntroductionHeat shock protein 70 (HSP70) expression could be discussed as an adaption that promotes repair and counteracts cell damage. Myoglobin is released upon muscle damage of several pathways. The purpose of the present study was to determine whether the expression of HSP70 in kidney, heart and brain and of myoglobin in the kidney were associated with the cause of death and the survival times after lethal intoxications with three of the drugs most widely used in our local area (Saxony, Germany) as well as after fatal traumatic brain injury (TBI).MethodsWe retrospectively collected kidney, heart and brain samples of 50 autopsy cases with toxicological proved lethal intoxication (main drugs methamphetamine, morphine, alcohol), 14 TBI cases and 15 fatalities with acute myocardial injury in age- and gender-matched compilations.ResultsOur main findings suggest that HSP70 is associated with hyperthermal and other stress factors of most cell populations. HSP70 expressions in kidney and heart muscle are useful for a differentiation between fatal intoxications and cases without toxicological influence (p < 0.05). There were significant differences in the cerebral expression patterns between methamphetamine- and morphine-associated deaths compared to alcohol fatalities (p < 0.05). An intensive staining of HSP70 in the pericontusional zone and the hippocampus after TBI (especially neuronal and vascular) was shown even after short survival times and may be useful as an additional marker in questions of vitality or wound age. A relevant myoglobin decoration of renal tubules was only shown for methamphetamine abuse in the study presented.ConclusionIn sum, the immunohistochemical characteristics presented can be supportive for determining final death circumstances and minimal trauma survival times but are not isolated usefully for the detection of drug- or trauma-induced hyperthermia.

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“…In der Literatur finden sich 2 ähnlich gelagerte Fallberichte [6,7]. In beiden Fällen handelte es sich um schwere, lebensbedrohliche Intoxikationen, die nach intensivmedizinischer Therapie überlebt wurden.…”

Section: Literaturunclassified

Ecstasy-Intoxikation mit disseminierter intravasaler Gerinnung und Multiorganversagen

Jochum¹,

Oeding²,

Lackner³

et al. 2017

Anästhesiol Intensivmed Notfallmed Schmerzther

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This case presents the clinical treatment of a patient with severe MDMA intoxication. The history of stimulating psychotropic substances is presented as well as the modes of action of current party drugs. Data from the Austrian Drug Report indicate a tendency away from "hard drugs" towards the consumption of cannabis and amphetamine derivates. The lethal outcome in our case demonstrates the risk potential of these substances and underlines the necessity of aggressive resuscitation efforts.

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Ausgeprägte Hyperthermie und Rhabdomyolyse nach Ecstasy (MDMA)-Intoxikation

Cited by 16 publications

References 9 publications

Molecular and Cellular Mechanisms of Ecstasy-Induced Neurotoxicity: An Overview

Molecular and Cellular Mechanisms of Ecstasy-Induced Neurotoxicity: An Overview

Drug- and/or trauma-induced hyperthermia? Characterization of HSP70 and myoglobin expression

Ecstasy-Intoxikation mit disseminierter intravasaler Gerinnung und Multiorganversagen

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