PMID- 28766722
OWN - NLM
STAT- MEDLINE
DCOM- 20180525
LR  - 20220317
IS  - 1556-4029 (Electronic)
IS  - 0022-1198 (Linking)
VI  - 63
IP  - 3
DP  - 2018 May
TI  - Fatal Diabetic Ketoacidosis-A Potential Complication of MDMA (Ecstasy) Use.
PG  - 939-941
LID - 10.1111/1556-4029.13602 [doi]
AB  - A 19-year-old woman with insulin-dependent diabetes mellitus was found dead in 
      bed having allegedly recently taken ecstasy and consumed alcohol. At autopsy, 
      there were microhemorrhages in the brain with subnuclear vacuolization and 
      Armanni-Ebstein changes in renal tubules. Biochemical analyses confirmed diabetic 
      ketoacidosis (vitreous glucose-46.5 mmol/L; beta-OH butyrate-13.86 mmol/L.). 
      Toxicological analyses of blood showed a low level of 
      3,4-methylenedioxy-methamphetamine (MDMA) (0.01 mg/L), with acetone but no 
      alcohol or other common drugs. Death was attributed to diabetic ketoacidosis most 
      likely provoked by mixed MDMA/alcohol ingestion. Although the use of illicit 
      drugs by young individuals with diabetes mellitus is being increasingly 
      recognized, it has been noted that there is minimal information about the 
      relationship between drug use and acute diabetic complications. Toxicological 
      screening of cases of lethal diabetic ketoacidosis in the young may clarify 
      lethal mechanisms in individual cases and also help to determine the extent of 
      this problem.
CI  - (c) 2017 American Academy of Forensic Sciences.
FAU - Gilbert, John D
AU  - Gilbert JD
AD  - Forensic Science SA, 21 Divett Place, Adelaide, 5000, Australia.
FAU - Byard, Roger W
AU  - Byard RW
AD  - Forensic Science SA, 21 Divett Place, Adelaide, 5000, Australia.
AD  - School of Medicine, The University of Adelaide, Frome Rd, Adelaide, 5005, 
      Australia.
LA  - eng
PT  - Case Reports
DEP - 20170802
PL  - United States
TA  - J Forensic Sci
JT  - Journal of forensic sciences
JID - 0375370
RN  - 0 (Hallucinogens)
RN  - KE1SEN21RM (N-Methyl-3,4-methylenedioxyamphetamine)
SB  - IM
MH  - Alcohol Drinking/adverse effects
MH  - Cerebral Hemorrhage/pathology
MH  - Diabetes Mellitus, Type 1/*complications
MH  - Diabetic Ketoacidosis/*diagnosis
MH  - Epithelial Cells/pathology
MH  - Fatal Outcome
MH  - Female
MH  - Hallucinogens/*adverse effects
MH  - Humans
MH  - Kidney/pathology
MH  - Kidney Tubules/pathology
MH  - N-Methyl-3,4-methylenedioxyamphetamine/*adverse effects
MH  - Vacuoles/pathology
MH  - Young Adult
OTO - NOTNLM
OT  - MDMA
OT  - death
OT  - diabetes mellitus
OT  - ecstasy
OT  - forensic science
OT  - hyperglycemia
OT  - ketoacidosis
EDAT- 2017/08/03 06:00
MHDA- 2018/05/26 06:00
CRDT- 2017/08/03 06:00
PHST- 2017/06/07 00:00 [received]
PHST- 2017/06/22 00:00 [revised]
PHST- 2017/06/23 00:00 [accepted]
PHST- 2017/08/03 06:00 [pubmed]
PHST- 2018/05/26 06:00 [medline]
PHST- 2017/08/03 06:00 [entrez]
AID - 10.1111/1556-4029.13602 [doi]
PST - ppublish
SO  - J Forensic Sci. 2018 May;63(3):939-941. doi: 10.1111/1556-4029.13602. Epub 2017 
      Aug 2.