Isolated non-cardiogenic pulmonary edema — A rare complication of MDMA toxicity

• Published in: The American journal of emergency medicine Vol. 35; no. 9; pp. 1385.e3 - 1385.e6
• Main Authors: Haaland, Astrid, Warman, Elliot, Pushkar, Illya, Likourezos, Antonios, Friedman, Matt S.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2017; Elsevier Limited
• Subjects: Alcohol; Amphetamines; ARDS; Case reports; Cocaine; Dopamine; Drug dosages; Ecstacy; Ecstasy; Edema; Emergency medical care; Event medicine; Fever; Fever - chemically induced; Holidays; Humans; Intoxication; Intubation; Intubation, Intratracheal; Male; Mass gathering medicine; MDMA; Mechanical ventilation; Methamphetamine; Music festivals; N-Methyl-3,4-methylenedioxyamphetamine - poisoning; Patient presentation rate; Pulmonary edema; Pulmonary Edema - chemically induced; Respiration, Artificial; Respiratory distress syndrome; Respiratory Distress Syndrome, Adult - chemically induced; Respiratory Distress Syndrome, Adult - therapy; Serotonin; Toxicity; Young Adult; Ecstacy; MGM; Mass gathering medicine; Patient presentation rate; EDMF; EMS; Event medicine; Pulmonary edema; ARDS; NCPE; MDMA
• ISSN: 0735-6757; 1532-8171
• DOI: 10.1016/j.ajem.2017.06.040

This is a case of a 19-year-old male who presented to the medical tent at an outdoor electronic dance music festival (EDMF) due to an altered mental state in the setting of acute 3,4-methylenedioxymethamphetamine (MDMA) intoxication. He was noted to be in severe respiratory distress, required endotracheal intubation in the field and subsequently developed Acute Respiratory Distress Syndrome (ARDS) without other acute organ dysfunction. He was hospitalized for 5days requiring endotracheal intubation and mechanical ventilation. By presenting this case, we will explore and discuss the cardiopulmonary effects of MDMA intoxication that can lead to a rare, deleterious complication of MDMA intoxication other than previously reported adverse outcomes.