HAIR ANALYSIS IN THE DIAGNOSIS OF TOXIC H EPATITIS AFTER DRUG-ABUSE WITH ]]ECSTACY[[

History,and clinical findings: A young man, aged 18 years, was admitte d to hospital for suspected hepatitis, having developed increasing jau ndice without any pain. His urine was light brown in colour and the st ools often liquid and pale. Every 14 days for the last 4 months he had been taking 2 tablets of >>ecstacy<< (methylenedioxymetamfetamine; MD MA). Physical examination was unremarkable and the patient was in good general condition. Tests: The activities of GOT, GPT and alkaline pho sphatase were raised (to 903, 744 and 270 U/l, respectively) as was th e bilirubin concentration (16.8 mg/dl). Tests were negative for: lepto spira and the viruses of mumps, HI, varicella tester, Picorna coma, cy tomegaly, Coxsackie and hepatitis, A, B and C. Ultrasound revealed hep atomegaly, with a normal echo pattern. Hair analysis demonstrated, in two different hair segments (0-2 cm and 2-4 cm, respectively) both MDM A (6.4 and 4.3 mu g/g hair) and its metabolite MDA (0.7 and 5.0 mu g/g hair). Treatment and course: No specific treatment was required. Afte r intake of the drug had been stopped the transferase activities and b ilirubin concentration became essentially normal. Conclusion: Hair ana lysis can be valuable in confirming >>ecstacy<< abuse, especially when it is denied, and thus contribute to clarifying the cause of toxic he patitis.