Thrombotic Thrombocytopenic Purpura after Ecstasy-Induced Acute Liver Failure

Letters19 January 1999Thrombotic Thrombocytopenic Purpura after Ecstasy-Induced Acute Liver FailureCarl Albrecht Schirren, MD, Thomas M. Berghaus, MD, and Michael Sackmann, MDCarl Albrecht Schirren, MDLudwig-Maximilians-Universität; 81377 Munich, GermanySearch for more papers by this author, Thomas M. Berghaus, MDLudwig-Maximilians-Universität; 81377 Munich, GermanySearch for more papers by this author, and Michael Sackmann, MDLudwig-Maximilians-Universität; 81377 Munich, GermanySearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-130-2-199901190-00020 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:A 20-year-old man was admitted to the hospital with a 6-day history of progressive fatigue and jaundice. Laboratory tests revealed markedly elevated liver enzyme levels and reduced synthesis of clotting factors. Electrolyte levels, creatinine level, leukocyte count, thrombocyte count, hemoglobin level, lactate dehydrogenase level, and pancreatic enzyme levels were in the normal range. Disseminated intravascular coagulation, hemochromatosis, Wilson disease, and infectious and autoimmune hepatitis were excluded.While recovering from acute liver failure, the patient became delirious and developed acute renal failure, acute pancreatitis, pronounced thrombocytopenia, microangiopathic hemolytic anemia, epistaxis, and petechial hemorrhage. A blood smear revealed fragmentocytes. ...References1. Henry JA. Ecstasy and the dance of death. BMJ. 1992;305:5-6. CrossrefMedlineGoogle Scholar2. Ginsberg MD, Hertzman M, Schmidt-Nowara WW. Amphetamine intoxication with coagulopathy, hyperthermia, and reversible renal failure. Ann Intern Med. 1970;73:81-5. LinkGoogle Scholar3. Henry JA, Jeffreys KJ, Dawling S. Toxicity and deaths from 3,4-methylenedioxymethamphetamine (“ecstasy”). Lancet. 1992;340:384-7. CrossrefMedlineGoogle Scholar4. Tumlin JA, Sands JM, Someren A. Haemolytic-uremic syndrome following “crack” cocaine inhalation. Am J Med Sci. 1990;299:366-71. CrossrefMedlineGoogle Scholar5. Levine SR, Brust JC, Futrell N, Ho KL, Blake D, Millikan CH, et al . Cerebrovascular complication of the use of the “crack” form of alkaloidal cocaine. N Engl J Med. 1990;323:699-704. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Ludwig-Maximilians-Universität; 81377 Munich, Germany PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byThrombotic thrombocytopenic purpura and focal segmental glomerulosclerosis associated with the use of ecstasyFulminant thrombotic thrombocytopenic purpura (TTP): association with amphetamine consumption?Disorders of Red Cells and PlateletsTacrolimus-induced thrombotic microangiopathy in orthotopic liver transplant patients: case series of four patientsNiacin Toxicity Resulting From Urine Drug Test Evasion SchemeAmphetamines and DerivativesDrug-induced Thrombotic Thrombocytopenic Purpura/Hemolytic Uremic Syndrome: A Concise ReviewThrombotic thrombocytopenic purpura (TTP) presenting as pancreatitisEl «éxtasis»: una revisión de la bibliografía científica sobre la 3,4-metilendioximetanfetaminaEvaluation of Liver Function in Type 2 Diabetic Patients During Clinical Trials: Evidence that rosiglitazone does not cause hepatic dysfunctionVariabilidad de la expresión clínica de la toxicidad hepática por éxtasisThrombotic thrombocytopenic purpura presenting as bilateral flank pain and hematuria: a case report 19 January 1999Volume 130, Issue 2Page: 163KeywordsAcute liver failureAcute renal failureAutoimmune diseasesEnzymesHemorrhageInfectious diseasesMagnetic resonance imagingPlateletsThrombotic thrombocytopenic purpuraVasoconstriction Issue Published: 19 January 1999 Copyright & PermissionsCopyright © 1999 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...