Budisavljevic Milos N, Stewart Lisa, Sahn Steven A, Ploth David W
Nephrology Division, Division of Pulmonary and Critical Care Medicine, Medical University of South Carolina, 171 Ashley Avenue, Charleston, NC 29425, USA.
Am J Med Sci. 2003 Aug;326(2):89-93. doi: 10.1097/00000441-200308000-00006.
We present a case of acute, symptomatic hyponatremia in a young woman that developed after use of 3,4-methylenedioxymethylamphetamine (MDMA), more commonly known as "ecstasy." The patient was treated with 5% saline and had complete recovery. The pathogenesis of MDMA-associated hyponatremia involves excessive water intake and inappropriately elevated antidiuretic hormone (ADH) levels. It seems that young, premenopausal women are at particularly high risk for the development of severe, symptomatic hyponatremia after use of this drug. Review of the literature revealed 4 fatal outcomes from MDMA-associated hyponatremia. All were women and all died from cerebellar tonsillar herniation. We suggest that acute hyponatremia that develops after MDMA use may be a life-threatening condition. Recent recommendation that MDMA users should drink large volumes of water may not be appropriate.
我们报告一例年轻女性在使用3,4-亚甲基二氧甲基苯丙胺（MDMA）（俗称“摇头丸”）后发生的急性症状性低钠血症。患者接受5%盐水治疗后完全康复。MDMA相关性低钠血症的发病机制涉及水摄入过多和抗利尿激素（ADH）水平不适当升高。似乎年轻的绝经前女性在使用该药物后发生严重症状性低钠血症的风险特别高。文献回顾显示，MDMA相关性低钠血症有4例致命结局。所有均为女性，均死于小脑扁桃体疝。我们认为，MDMA使用后发生的急性低钠血症可能是一种危及生命的状况。最近建议MDMA使用者应大量饮水可能并不合适。
