MDMA (3,4-Methylenedioxy-Mmethamphetamine) and Cannabis Intake Resulting in Multiple Organ Failure, Hypoglycemia, Disseminated Intravascular Coagulation (DIC), and Methemoglobinemia

Introduction: Drug abuses have become an important part of the emergency service admissions. As a result of MDMA (3,4- methylenedioxy-methamphetamine) intake, various side effects may occur; from minor to major conditions. After using cannabis alone there appears cardiovascular symptoms, respiratory symptoms, nausea/vomiting, and neurological symptoms. We presented the MDMA and cannabis intake case which resulted in multiple major adverse events and death in the emergency department. Case report: A nineteen-year-old male patient was brought to the emergency department with generalized tonic-clonic seizure. On admission, the patient had hypoglycemia and his urine was positive for cannabis and amphetamine. Liver, renal failure, DIC, and methemoglobinemia developed. Although he received noradrenaline and dopamine infusion due to hypotension, his hypotension deepened. During the follow-up, cardiac arrest developed and after 30 minutes of cardiopulmonary resuscitation, death was accepted. Discussion: The current study discusses a phenomenon in which severe side effects occured after the intake of MDMA and cannabis that resulted in death. MDMA is inhibited by the CYP2D6 enzyme and is excreted renally. The presence of drugs that inhibit this enzyme, the development of kidney failure, and the genetic polymorphism of the enzyme may cause these effects. Conclusion: In light of this study, it is concluded that the use of street drugs can cause death with many serious side effects.