Acute liver damage and ecstasy ingestion.
A J Ellis, J A Wendon, B Portmann, R Williams
Institute of Liver Studies, King's College School of Medicine and Dentistry, London.
Eight cases of ecstasy related acute liver damage referred to a specialised liver unit are described. Two patients presented after collapse within six hours of ecstasy ingestion with hyperthermia, hypotension, fitting, and subsequently disseminated intravascular coagulation with rhabdomyolysis together with biochemical evidence of severe hepatic damage. One patient recovered and the other with evidence of hyperacute liver failure was transplanted but subsequently died, histological examination showing widespread microvesicular fatty change. Four patients presented with acute liver failure without hyperthermia. All four fulfilled criteria for transplantation, one died before a donor organ became available, and two died within one month post-transplantation of overwhelming sepsis. Histological examination showed submassive lobular collapse. Two patients presented with abdominal pain and jaundice and recovered over a period of three weeks; histological examination showed a lobular hepatitis with cholestasis. Patients developing jaundice or with evidence of hepatic failure particularly encephalopathy and prolongation of the international normalised ratio, or both, whether or not preceded by hyperthermia, should be referred to a specialised liver unit as liver transplantation probably provides the only chance of recovery.
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I hope you are feeling better now....I also hope you don't try it again. Please let us know how you are feeling!
Take Care,
JoAnn
Acute Liver Failure Following the Use of Ecstasy (MDMA)
by
Lange-Brock N, Berg T, Muller AR, Fliege H,
Neuhaus P, Wiedenmann B, Klapp BF, Monnikes H.
Medizinische Klinik mit Schwerpunkt Psychosomatik und
Psychotherapie des Universitatsklinikum Charite
der Humboldt-Universitat zu Berlin.
Z Gastroenterol 2002 Aug;40(8):581-6
ABSTRACT
The use of "ecstasy" (Methylenedioxymethamphetamine) as a recreational drug is increasing in europe since the 1980's. Aside intended psychological effects the use of ecstasy can be followed by symptoms of intoxication; complications include toxic hepatic damage up to acute hepatic failure. This case-report is about a 17-year old female patient who regularly used "ecstasy" over a six-month period. Two days after the last use of "ecstasy", she reported to her general practitioner with nausea, vomiting, abdominal pain and jaundice. Within 10 days the patient developed acute liver failure. With criteria for liver transplantation fulfilled she was listed for orthotopic liver tranplantation of high urgency which was carried out only one day later. Histological examination of the explanted liver showed evidence for a toxic fulminant hepatitis. After transplantation the patient made a full recovery and was released from hospital on day 26 after transplantation. At the first control after six months the patient was in good physical and nutritional condition, serological parameters were normal and ultrasound examination of the transplanted liver was unremarkable. The ethiopatology of "ecstasy"-induced hepatotoxicity, which can occur dose-independently with a symptom-free period from days to weeks after ingestion is not yet fully understood. Possible mechanisms of hepatic damage include influence of MDMA on body temperature regulation, harmful effects of the substance or further components of the "ecstasy"-tablets on the liver cell or a genetic vulnerability of some individuals against amphetamines and amphetamine derivates. There are no parameters existing which could predict the course and severity of "ecstasy"-induced hepatopathy. Especially in young patients with symptoms of hepatic damage frequent controls of clinical status and relevant laboratory parameters are of great importance. Patient transfer to a specialised centre should follow as early as possible; at the latest, when coagulopathy occurs.
Thank you for you're advice. In regards to my liver, it's abnormal T liver condition and im still waiting for the full results.
p.s. my friend actually gave me a Sprite a while ago, and im feeling a bit better.
Okay - This isnt easy to do over a 'puter, but..... it sounds to me like you may be slightly dehydrated and laying down then popping back up for the walk to the kitchen put you in what is called postural hypotension. Low blood pressure from getting up and walking combined with fluid loss from vomiting just dropped you. I am familiar with the liver problems. Depending on your situation you need to realise that you will not metabolize any med the same way other people do.....you need to be very careful. When you get up - do it in stages. Sit before you fully rise. Take some time. Breathing exercises will help. So will more fluid. White grape juice is good. So is warm flat (open and sit out) 7-UP........PM me if you want to talk about the liver anymore - but be careful!!