PMID- 22640978
OWN - NLM
STAT- MEDLINE
DCOM- 20140825
LR  - 20151119
IS  - 1525-1489 (Electronic)
IS  - 0885-0666 (Linking)
VI  - 28
IP  - 4
DP  - 2013 Jul-Aug
TI  - Multiple MDMA (Ecstasy) overdoses at a rave event: a case series.
PG  - 252-8
LID - 10.1177/0885066612445982 [doi]
AB  - Twelve patients with 3,4-methylenedioxymethamphetamine (MDMA) toxicity from a 
      single rave event presented to multiple San Francisco Bay area hospitals with 
      various life-threatening complications including seizures and hyperthermia. Eight 
      required emergent endotracheal intubation and six had hypotension. Hyperkalemia, 
      acute kidney injury, and rhabdomyolysis were present in most of the patients. In 
      all, 2 patients died, 4 survived with permanent neurologic, musculoskeletal, 
      and/or renal sequelae, and 6 survived without any apparent lasting deficits. 
      Hyperthermia was present in 10 patients and was severe (40.9-43 degrees  C) in 7. Using 
      multiple cooling methods, the average time to achieve cooling was 2.7 hours. 
      Serum drug analysis was performed on 3 patients, demonstrating toxic MDMA 
      concentrations without the presence of other xenobiotics. Two capsules 
      confiscated by police at the event contained 82% and 98% MDMA, respectively, 
      without other pharmacologically active compounds. Capsule #2 contained 270 mg 
      MDMA, which is more than twice the amount of MDMA usually contained in 1 dose. 
      The MDMA-induced hyperthermia significantly contributed to the morbidity and 
      mortality in this case series. Factors contributing to the severity of the 
      hyperthermia include ingestion of large doses of MDMA, a warm ambient 
      environment, and physical exertion.
FAU - Armenian, Patil
AU  - Armenian P
AD  - Department of Emergency Medicine, University of California, San Francisco-Fresno, 
      Fresno, CA 93701, USA. patilarmenian@gmail.com
FAU - Mamantov, Tanya M
AU  - Mamantov TM
FAU - Tsutaoka, Ben T
AU  - Tsutaoka BT
FAU - Gerona, Roy R L
AU  - Gerona RR
FAU - Silman, Eric F
AU  - Silman EF
FAU - Wu, Alan H B
AU  - Wu AH
FAU - Olson, Kent R
AU  - Olson KR
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20120528
PL  - United States
TA  - J Intensive Care Med
JT  - Journal of intensive care medicine
JID - 8610344
RN  - 0 (Hallucinogens)
RN  - KE1SEN21RM (N-Methyl-3,4-methylenedioxyamphetamine)
SB  - IM
MH  - Adult
MH  - Critical Care/methods
MH  - Drug Overdose/complications/epidemiology/*therapy
MH  - Emergency Service, Hospital/statistics & numerical data/trends
MH  - Female
MH  - Hallucinogens/*adverse effects
MH  - Humans
MH  - Length of Stay/statistics & numerical data
MH  - Male
MH  - N-Methyl-3,4-methylenedioxyamphetamine/*adverse effects
MH  - San Francisco/epidemiology
MH  - Treatment Outcome
MH  - Young Adult
OTO - NOTNLM
OT  - MDMA
OT  - critical care
OT  - ecstasy
OT  - hyperthermia
OT  - toxicology
EDAT- 2012/05/30 06:00
MHDA- 2014/08/26 06:00
CRDT- 2012/05/30 06:00
PHST- 2012/05/30 06:00 [entrez]
PHST- 2012/05/30 06:00 [pubmed]
PHST- 2014/08/26 06:00 [medline]
AID - 0885066612445982 [pii]
AID - 10.1177/0885066612445982 [doi]
PST - ppublish
SO  - J Intensive Care Med. 2013 Jul-Aug;28(4):252-8. doi: 10.1177/0885066612445982. 
      Epub 2012 May 28.