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Fatal hyponatremia in a young woman after ecstasy ingestion

Nature Clinical Practice Nephrology volume 2, pages 283–288 (2006)Cite this article

Abstract

Background A 20-year old, otherwise healthy, female college student presented in an unresponsive state with respiratory distress after ingesting ecstasy (3,4-methylenedioxymethamphetamine). She had initial plasma sodium concentration of 117 mmol/l.

Investigations Physical examination, blood chemistry panel, urinary osmolality and electrolytes, arterial blood gas, chest X-ray, and CT scan of the brain.

Diagnosis Hyponatremia associated with noncardiogenic pulmonary edema and cerebral edema.

Management Administration of a total of 6.8 l of isotonic saline and 0.245 l of 3% hypertonic saline with sporadic administration of intravenous furosemide. The patient died approximately 12 h after admission.

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Figure 1: Chest X-ray of 20-year-old woman with a plasma sodium concentration of 117 mmol/l after ecstasy (3,4-methylenedioxymethamphetamine) ingestion.
Figure 2: Algorithm for treatment of premenopausal women with hyponatremia.

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Acknowledgements

K Kalantar-Zadeh is supported by the NIH grant DK61162 and I Kurtz is supported by the NIH grants DK63125, DK58563, DK07789, the Max Factor Family Foundation, the Richard and Hinda Rosenthal Foundation, and the Fredrika Taubitz Fund.

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Authors and Affiliations

  1. Associate Professor of Medicine and Pediatrics and Director of the Dialysis Expansion Program and Epidemiology at Harbor-UCLA Division of Nephrology and Hypertension,

    Kamyar Kalantar-Zadeh, Minhtri K Nguyen & Ira Kurtz

  2. Assistant Professor of Medicine and Director of Consultative Nephrology in the Division of Nephrology,

    Kamyar Kalantar-Zadeh, Minhtri K Nguyen & Ira Kurtz

  3. Chief of Nephrology, Professor of Medicine, Factor Chair in Molecular Nephrology, and Director of the Molecular Physiology and Biophysics Transport Laboratory at UCLA, Torrance, CA, USA

    Kamyar Kalantar-Zadeh, Minhtri K Nguyen & Ira Kurtz

  4. St Joseph's Hospital, Orange, CA, USA

    Roger Chang

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  1. Kamyar Kalantar-Zadeh
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  2. Minhtri K Nguyen
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Corresponding author

Correspondence to Kamyar Kalantar-Zadeh.

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The authors declare no competing financial interests.

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Kalantar-Zadeh, K., Nguyen, M., Chang, R. et al. Fatal hyponatremia in a young woman after ecstasy ingestion. Nat Rev Nephrol 2, 283–288 (2006). https://doi.org/10.1038/ncpneph0167

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