Ecstasy hyponatremia with

In a retrospective analysis of all cases of hyponatremia associated with ecstasy (SEDA-25, 37) at the London Centre of the National Poisons Information Service from December 1993 to March 1996,17 patients were identified with a serum sodium concentration under 130 (range 107-128 mmol/1) (96). In 10, ecstasy was identified analytically, and six of them had SIADH. The clinical presentation was very consistent, with initial vomiting and delirium, and 11 had seizures. There was complete recovery in 14, but two died of cerebral edema 5 hours after ingestion. 

Two deaths in patients with hyponatremia after ecstasy intoxication have been reported (98). 

A 19-year-old woman became disoriented and had hyponatremia (131 mmol/1) and a serum ethanol concentration of 2.4 mmol/1. Her serum sodium had fallen to 120 mmol/1 10 hours later, and 5 hours later she suddenly deteriorated and had a respiratory arrest, coma, and sinus tachycardia of 180/minute with bige-miny. A CT scan showed diffuse edema in the posterior fossa. She was considered brain dead 23 hours after taking the ecstasy. 

The authors thought that this was the first report of acute transient proximal tubular injury with ecstasy. In contrast to SIADH, there was a high urine output in the presence of hyponatremia and solute diuresis. 

Budisavljevic MN, Stewart L, Sahn SA, Ploth DW. Hyponatremia associated with 3,4-methylenedioxymethy-lamphetamine ( ecstasy ) abuse. Am J Med Sci 2003 326 89-93. 

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