Roques V, Perney P, Beaufort P, Hanslik B, Ramos J, Durand L, Le Bricquir Y, Blanc F
Service de Médecine interne, Hôpital Saint-Eloi, Montpellier.
Presse Med. 1998 Mar 14;27(10):468-70.
Ecstasy is a synthetic amphetamine which causes a wide variety of adverse effects. Hepatic toxicity was only recently demonstrated but can be quite severe.
A 27-year-old male with no past medical or surgical history developed jaundice without fever. He was a regular user of ecstasy and had recently increased the number of doses consumed. No evidence of a viral, alcoholic, metabolic or autoimmune mechanism was found which could explain the hepatitis. Complete cure was obtained by discontinuing ecstasy.
Few cases of ecstasy hepatic toxicity have been reported. Ecstasy was undoubtedly the causal agent in this case since other known causes of acute hepatitis were excluded, confirming the hepatotoxicity of ecstasy reported in the literature. The liver disease has been reported to range form acute regressive hepatitis to fatal liver failure. Iterative exposure can lead to fibrosis. The pathophysiological mechanism of this toxic effect is not well elucidated. Ischemia alone cannot explain all the clinical forms described, particularly cases without hyperpyrexia. Ecstasy must be added to the list of potential causes of acute hepatitis. Exposure must always be searched for in cases of acute hepatitis in young subjects.
摇头丸是一种合成苯丙胺，会引发多种不良反应。肝毒性直到最近才被证实，但可能相当严重。
一名27岁男性，无既往内科或外科病史，出现黄疸且无发热。他经常使用摇头丸，近期服用剂量增加。未发现病毒、酒精、代谢或自身免疫机制导致肝炎的证据。停用摇头丸后完全治愈。
很少有关于摇头丸肝毒性的病例报道。在本病例中，摇头丸无疑是病因，因为排除了其他已知的急性肝炎病因，证实了文献中报道的摇头丸肝毒性。据报道，肝脏疾病范围从急性消退性肝炎到致命性肝衰竭。反复接触可导致纤维化。这种毒性作用的病理生理机制尚未完全阐明。仅缺血不能解释所有描述的临床症状，特别是无高热的病例。摇头丸必须被列入急性肝炎的潜在病因清单。对于年轻患者的急性肝炎病例，必须始终排查是否有接触摇头丸的情况。
